TOP-5 exercises for arthrosis of the shoulder joint according to the method of Dr. Sergei Bubnovsky

Practice shows that diseases of the shoulder joint always begin with discomfort as a result of a long stay in a sedentary state.

Shoulder joint, symptoms of diseases Shoulder joint, treatment of diseases with kinesitherapy Treatment of the shoulder joint with exercises at home

The shoulder joint is spherical in shape, as part of the skeleton, it connects and ensures mobility of the humerus relative to the scapula of the upper limb girdle.

Industrial gymnastics for office workers, including movements for the muscles of the shoulder girdle, will make it possible to avoid pain syndromes and reduce the likelihood of glenohumeral periarthritis, arthrosis and arthritis of the shoulder joint

. Discomfort and pain in the arms occur mainly in the absence of physical activity on the shoulder joints and only 25% are associated with diseases of the shoulder joints.

The effectiveness of Bubnovsky gymnastics

Professor Bubnovsky advocates the treatment of shoulder arthrosis using exercises with additional weights in the form of gymnastic block exercise machines, rubber expanders or simple dumbbells.

Doctor Bubnovsky

The effectiveness of Bubnovsky’s technique is explained by the fact that during muscle loading a large number of anti-inflammatory agents are released that block the breakdown of arachidonic acid. Due to this, swelling and pain are reduced and muscle spasm is relieved.

Due to the fact that muscle spasm is relieved, the phenomena associated with blocking the outflow and inflow of blood through the veins and arteries disappear. This leads to normalization of metabolism in cartilage tissue and improvement of the trophic capabilities of synovial fluid.

Due to the active load, more synovium enters the joint cavity, which is necessary to absorb the work of the shoulders during exercises or physical work.

The main goals of exercises for arthrosis of the shoulder joint according to Bubnovsky:

complete restoration of motor function of the shoulder joint;
reduction of swelling;
pain relief.

Initial results can be achieved in 1–2 weeks, and permanent stable remission can be achieved in 2–3 months.

Deltoid

I.P. sitting on a chair, with his back to the NOP. The simulator is fixed at the lowest point of the LOP. Raising straight arms with a simulator from the bottom up. To start, just raise your arms to chest level. Aerobatics - raising your arms to a vertical position. But this option for performing the exercise should be approached gradually. Perform 15–20 repetitions.

It has no contraindications.

This exercise is narrow-local, since only the muscles of the shoulder joint (deltoid) are involved in it, so the thinnest rubber simulator is used to perform it. Indications: diseases such as glenohumeral periarthritis, headaches, cervical osteochondrosis, shoulder injuries and dislocations.

General principles

Dr. Bubnovsky’s exercise technique will be effective if you follow the basic principles of exercise therapy. To do this you need:

Perform all exercises after preliminary warm-up or massage;
exhale during muscle contraction, and inhale when relaxing;
Drink no more than 1 sip of water between exercises;
If pain occurs, stop the exercise or replace it with a simpler one;
perform exercise therapy systematically, 2–3 times a week (maximum 5–6 times a week);
start physical activity provided that the last meal was at least two hours ago;
Do not perform exercises, massages or exercises in the presence of acute inflammatory processes accompanied by pain and swelling of the shoulder joint.

Gymnastics can be done for any degree of arthrosis, the main thing is to control the range of motion and monitor the appearance of pain. With stages 1–2 of arthrosis, you can perform more sweeping movements with weights, and with stage 3, you can pay attention to static exercises, movements with a small amplitude and without weight.

They do exercises mainly in the morning, since at this time some stiffness and pain may be observed in the joint with sudden movements.

By doing exercises in the evening, you ensure your muscles relax before going to bed. This has a good effect on accelerating metabolic processes and regenerating cartilage tissue.

Based on this, the optimal time for carrying out therapeutic exercises according to Bubnovsky is morning and evening. Light exercises with gymnastic bands can be done in the morning, and exercises with exercise machines and dumbbells in the evening.

Before starting therapeutic exercises, you need to do a short warm-up for your shoulders, which includes light, stretching and low-amplitude movements.

Warm-up before starting Bubnovsky exercises:

Sitting on a chair, place the palm of your hand on the opposite shoulder, and grab your elbow with the other hand. Smoothly move your palm from your shoulder to your spine. When performing the exercise, the other hand helps stretch the shoulder while supporting the elbow. Perform the exercise for 10–25 seconds on each arm. Number of exercises – 4–5 times. Number of approaches – 2–3.
Place your hands behind your head and clasp them together. At the same time, bring your arms forward, trying to touch each other with your elbows. Just as smoothly and simultaneously move your arms back as far as possible. Do 2-3 sets of 10-15 reps.
Place your fingertips on your shoulders and make circular movements with your elbows 10 times forward and 10 times back. Perform 2-3 approaches.
Grasp your hands behind your back. Smoothly move your hands, without breaking the lock, left and right. Repeat 10 times on each side, perform 2-3 sets.
Stand near a wall, place your hands on it and imitate push-ups. When bending your arms to the maximum at your elbow joints, try to bring your shoulder blades as close as possible. Repeat the exercise 15–20 times, perform 2–3 approaches.

If possible, massage your shoulder blades and shoulders before starting the exercises.

Exercises for general warm-up

For massage, it is necessary to lay the patient on his stomach, with his arms extended at the seams. Using circular massaging movements, knead the shoulder blades near the spine and on the sides of the body. Then the patient raises his arms up or to the sides. Rubbing should be carried out in the transition areas of the scapula on the shoulder. Then massage your shoulders on both sides in a circular motion.

You need to perform Bubnovsky exercises for arthrosis of the shoulder joint with both hands, regardless of the location of the pathological process.

Archer

I.P. the same as in the “Reverse Butterfly” exercise. But instead of abducting the straight arm, the machine is pulled in the direction from the lower leg to the shoulder. In this case, it is advisable to slightly twist the body when straightening the arm towards the LOP, stretching the latissimus dorsi and oblique abdominal muscles, and when pulling the machine, move the shoulder blade back. Perform the exercise 10–20 repetitions with each hand.

The exercise is similar to the previous one, but more gentle, since the arm bends at the final stage of the movement, which means that not only the deltoid muscles of the shoulder (usually weak, especially in women), but also the biceps of the arm, a larger and more resilient muscle, are involved in the movement.

The exercise is excellent in the treatment of glenohumeral periarthritis; it is also prescribed for tendinitis and bursitis of the elbow joint (“tennis elbow”), in addition, for injuries of the wrist joint, rheumatoid polyarthritis of the hands.

Thanks to this exercise, the hard-to-reach deep muscles of the spine are worked out, the weakest and most easily injured by unsuccessful twisting movements (for example, lifting buckets of water from the floor, moving heavy pots in the kitchen from the stove to the table). The resulting spasm of the deep muscles of the thoracic spine (rhomboid, trapezius, extensor dorsi), causing pain in the interscapular region, lasting for a long time and difficult to eliminate, helps relieve the described exercise.

There are no contraindications.

Set of exercises

The exercises should be started only after preliminary preparation. You should also stock up on the necessary equipment in the form of dumbbells, gymnastic bands and sticks. If possible, buy a block machine or go to the gym.

The most effective exercises are on block simulators.

Top 5 exercises for the treatment of arthrosis of the shoulder joint using the Bubnovsky method:

Exercise "Saw". Standing or sitting near the block exercise machine (you can use a gymnastic band attached to something), rest against the exercise machine with one hand, and with the other take the handle of the exercise machine and bend it at the elbow joint. Move your shoulders forward and backward, simulating working with a saw. Repeat at least 20 times, perform 2-3 approaches. Select the weight individually, based on your physical fitness. You can start with 5 kg. You should not work with weights exceeding 25 kg.
For the next exercise you will need dumbbells or a gymnastic band. If you choose an elastic band, you need to stand in the middle of it and grab the two free ends with your hands. While standing with an elastic band (or dumbbells) in your hands, alternately raise your arms in front of you and spread them to the sides. Repeat 15–20 times, perform 2–3 approaches. You need to start with a dumbbell weighing at least 2 kg.
In the same position with an elastic band or dumbbells, instead of raising and spreading your arms in front of you, you need to alternately raise your arms up above your head. You need to return your arms to their original position smoothly, without straightening the elbow joint. Repeat 10–15 times on each arm, perform 2–3 approaches.
Take a gymnastic stick in your hands. The grip should be shoulder-width apart or slightly wider. Smoothly lift the stick in front of you and up to its maximum height. Having reached the highest point, try to move the stick slightly back behind your head and hold it in this position for 2-3 seconds. Repeat 10-12 times, perform 2-3 approaches.
Stand near the wall so that all points of your back are in contact with it. Take dumbbells in your hands or first step on the center of the gymnastic band, taking it in your hands. In a position where your back is completely in contact with the wall, raise your arms up without lifting them from the wall.

Exercise 1 Exercise 3 Exercise 4 Exercise 5
If arthrosis does not recede, try adding new static exercises:

Bend your arms at the elbow joints, place your hands “in the lock.” Try to break the lock using the strength of your shoulder muscles. Hold in the maximum load position for 3-5 seconds. Perform 1-2 sets of 5-6 times.
Place your arms straight on the wall. Try to push it forward with all your strength. The tension should be done 4-6 times, perform 1-2 approaches. Each push should last 3-5 seconds.

Read about the method of charging the shoulder joint in this article.

French Press, or Parting Hands

The exercise strengthens the triceps, makes the back surface of the arm denser and more prominent, which helps to cope with such an unpleasant sign of triceps weakness in women as “farewell arms” (a condition of the arm muscles in women when they dangle with any movement). It is also successfully used in the treatment of pain syndromes of the elbow joint, such as tennis elbow, tendinitis or bursitis.

I.P. lying with your back on the fitball and holding the handles of one end of the exercise machine with your hands. Attach the other to the bottom of the NOP. Elbows raised above head.

Extending and bending the arms at the elbow joints while exhaling “Ha-a.” Try not to spread your elbows to the sides and keep them in one position, otherwise the exercise will lose its meaning. The number of movements is not limited, but at least 10, and preferably 15–20 repetitions until the arm muscles feel tired.

You can change I.P. (a simpler option), lying on your back on the floor or on a bench, and even standing with your back to the machine, but your elbows should be motionless regardless of the chosen starting position.

With elbow bursitis (swelling), pain may occur when performing this movement.

What medications can be used to consolidate the results of exercise therapy?

To make gymnastics more effective, before starting and at the end of training, you can use an ointment based on viper venom - Viprosal B. Before going to bed, to relax your muscles as much as possible, use cooling or anti-inflammatory ointments and gels. List of ointments that can be applied at night:

Diclak gel, SALUTAS PHARMA, Germany;
Lyoton gel, A.Menarini Manufacturing Logistics and Services, Italy;
Cryo-gel Reanimator, PhytoBioTechnologies, Russia.

Throughout the day, you can use any product containing ibuprofen, diclofenac, meloxicam.

Read about ointments for joints in this article.

From tablets, you can take ibuprofen at a dose of 200 mg 2-3 times a day.

Treatment of arthrosis with anti-inflammatory drugs has many side effects, so the course of therapy should not exceed 10 days without interruptions. The duration of the break is at least 1 week.

In addition to using pharmaceuticals to consolidate exercise therapy, you can additionally undergo a course of physical therapy:

massage;
hydromassage;
ozokerite therapy;
mud therapy;
electrophoresis.

Read about physiotherapy for joints in this article.

Results:

The Bubnovsky method of treating arthrosis of the shoulder joints is based on the use of additional weights and exercise equipment.
The minimum result can be achieved in 2-3 weeks of regular exercise.
You can exercise at any time of the day, with any degree of arthrosis.
Exercises should not bring pain or discomfort.
The main goals of gymnastics according to Bubnovsky are to accelerate metabolism in the joint, reduce swelling, pain, eliminate arthrosis and other manifestations of dystrophic changes in cartilage tissue.
Ointments, anti-inflammatory tablets, and physiotherapy are used as additional therapy for arthrosis.

Surgeon. Studied medicine at VNMU named after. N.I. Pirogova.

Aristotle also said that “movement is life,” rightly considering the musculoskeletal system to be the source of this movement. The great thinker and scientist considered healthy joints and spine to be the main condition for a decent life that every person deserves.

Indeed, “back problems” deprive people of the opportunity to enjoy life and work fully, and this is at best. At worst, loss of motor ability and disability. It’s the same with joints - when they are healthy, people move freely and can do their usual activities.

However, the older a person gets, the higher the likelihood of developing joint pathology, which makes itself felt by pain, stiffness of movement and other unpleasant symptoms. The cause of shoulder discomfort can be bursitis, arthritis, arthrosis, or traumatic injuries.

Gymnastics for the shoulder joint according to Bubnovsky, designed to activate the body's reserve forces, will help restore mobility and get rid of pain. Dr. Bubnovsky suggests strengthening the muscular-ligamentous apparatus of the upper shoulder girdle with exercises that can be performed at home.

Therapeutic gymnastics by Bubnovsky for arthrosis of the knee joint: a set of exercises

The author's technique is based on movement treatment, since most diseases arise due to a sedentary lifestyle. Sergei Mikhailovich has no doubt about this, and tries to convey this principle to patients. It is worth noting that he succeeds: in more than 30 years of active work, he has managed to cure more than one million patients suffering from diseases of the skeletal system.

Among the many innovative ideas brought to life was accelerated rehabilitation after compression fractures. As a result of early start of classes, some patients were able to avoid disability, while others no longer needed crutches. All this became possible thanks to the exercises for the shoulder joint that the victims performed.

Bringing back the joy of movement to people is the main task of doctor Bubnovsky

A gymnastic complex for the muscles of the shoulder girdle can be performed independently, but you should remember the basic principles of health-improving techniques:

breathe correctly - do not hold inhalation and exhalation, control the frequency of inhalations to maximize the supply of oxygen to the body;
increase the load and number of approaches gradually as you get used to the new movements;
a positive attitude is one of the most important conditions for successful treatment, so you should practice without doubting the result.

Exercises according to the Bubnovsky method are performed taking into account the disease. With glenohumeral periarthritis occurring in remission, the surface of the floor or rug should be smooth and hard. This will help eliminate or minimize pain in the shoulder girdle.

In the complex treatment of the shoulder joint, it is useful to do the following exercises:

You can also read: Dr. Bubnovsky’s gymnastics for the spine

clench and unclench your hands;
hug yourself by the shoulders, placing your left hand on your right shoulder and your right hand on your left. Inhale slowly and hold your breath for a few seconds. Then exhale slowly, lowering your arms along your body;
standing with legs wide apart, raise your arms up as you inhale, and lower as you exhale;
the starting position is the same, arms are extended forward, parallel to the floor;
moving your arms back is also performed from a standing position. You won’t be able to raise your arms high behind your back; a small movement is enough;
raising your arms to the sides. Can be done straight or slightly bent at the elbow joint;
Lie on your back, put your arms along your body. Without lifting your palms from the floor, raise your arms, slightly spreading your elbows to the sides;
starting position - lying on your back, arms raised up, the back of your head resting on your palms. Without raising your head, bring your elbows together;
after completing the previous exercise, stretch your arms along your body and lift them up one by one, while taking a deep breath;
sit on a chair or bench, put your feet wide, keep your back straight. You can lower your hands down or put them on your waist and make a figure-eight movement with your shoulders. Draw 6-8 horizontal eights and the same number of vertical ones with each shoulder;
sitting on a chair, alternately touch the scapula with your fingers, then moving your hand over the shoulder, then reaching to the bone of the scapula from below.

Having mastered these exercises, you can complicate the task and use dumbbells. If you don’t have any equipment at home yet, ordinary plastic water bottles will do instead of dumbbells. The weight of a dumbbell or bottle should be selected according to your strength, starting from 1 kg. For starters, this will be quite enough. Subsequently, the weight of the weight increases and can reach up to 10 kg.

Exercises with a gymnastic harness are useful for everyone and are not inferior in effectiveness to training with dumbbells

The doctor advises using special rubber bands as sports equipment. Elastic bands are widely used in sports medicine, since exercises with their use can strengthen the muscle corset and increase the body's endurance.

When performing gymnastics using dumbbells or bands, the number of repetitions of each exercise must be at least 20, the duration of the lesson starts from 15 minutes. The best time for the gymnastics complex is the first half of the day, preferably the morning hours.

It is possible that in the first days of performing therapeutic exercises the patient will experience pain or cramps - this should not be a reason to stop exercising. To cope with discomfort, you can apply ice or a cold compress to the damaged area, or take a contrast shower. After several charging cycles, the discomfort will go away.

However, it is important to know that if severe pain occurs, you must either reduce the intensity of your exercise or temporarily stop it. During exacerbations or the acute phase of the disease, exercise should also not be performed.

It is worth mentioning separately the features of exercise therapy after a shoulder dislocation. In this case, you should make an exception to the general rule and avoid pain during training. You need to start with the simplest exercises, since overloading the joint can lead to re-injury. A prerequisite is the correct execution of movements and a timely increase in load.

If you do the exercises strictly according to the instructions, without missing a single day and following all the recommendations, the result will be like this:

the range of motion in the joint will be fully or partially restored;
the pain will subside;
not only the shoulder joint, but the entire body will become more resistant to stress;
your mood and vitality will improve.

Using an expander, you can train almost any muscle group, including the shoulder girdle and upper limbs

Professor Bubnovsky is convinced that the key to healthy joints and spine is a strong muscular system. It is on the principle of strengthening the muscles and ligaments that the technique is built, which is a worthy alternative to medication and even surgical intervention.

The best proof of this theory, confirmed by many years of practice, is Sergei Mikhailovich himself. After a terrible accident while serving in the army, he was implanted with an artificial hip joint. Having gone through the same path as many patients, Bubnovsky understands perfectly how to help people. He tested his method on himself, and is the first to master each new simulator.

Today, Bubnovsky’s specialized kinesitherapy clinics operate not only in Moscow, but also abroad. Doctors at these centers also help those patients whom orthodox medicine could not cure.

The Bubnovsky system is an avoidance of taking pills, giving injections and parting with the disease by performing thoughtful physical exercises.

Joint diseases in the modern world are most common among the population of the middle and older age groups. This is due to the fact that the risk of joint damage increases with age.

But many people, already in their youth, have limited shoulder mobility, which makes it increasingly difficult to perform actions that are so necessary in everyday life. It is more difficult to dress, take care of children, and play sports. People usually begin to feel inferior and defective. This also affects a person’s mental state.

Treatment methods

In most cases, the disease can be managed using conservative methods. Complex treatment of the spine and joints usually includes:

taking medications (analgesics, NSAIDs, glucocorticosteroids, chondroprotectors, muscle relaxants, vitamin-mineral complexes);
therapeutic blockades - injections of painkillers and anti-inflammatory drugs into the site of inflammation;
use of local funds;
physiotherapeutic procedures (electrical stimulation, electrophoresis, phonophoresis, magnetic therapy, laser therapy, shock wave therapy, ultrasound therapy);
reflexology;
physical therapy;
massage, manual techniques;
diet therapy;
use of orthopedic devices.

The orthopedist selects therapeutic measures for each patient individually, taking into account the diagnosis, stage of the disease, the patient’s age, his activity, and the presence of other diseases. They are aimed at relieving inflammation, eliminating pain, restoring blood circulation, and improving tissue nutrition.

If conservative therapy is ineffective, which happens in advanced cases, the doctor will recommend surgery. At our hospital, surgeons prefer minimally invasive operations. They minimally injure the body, promote rapid rehabilitation, and minimize the risk of developing postoperative complications.

The specialists of our clinic for the treatment of the spine use in their work classical techniques that have proven themselves, as well as innovative technologies that have proven their effectiveness. During the examination, they use modern equipment, which ensures highly accurate results. And many years of experience of doctors, combined with extensive knowledge, allows you to choose the optimal treatment that ensures a quick recovery. Make an appointment at the Center for Traumatology and Orthopedics named after. ak. N.N. Burdenko and find out the cost of therapy by calling the numbers listed on the website.

Causes of shoulder pain

Pain in the shoulder joint occurs as a result of a wide variety of pathologies. Some of them include:

osteochondrosis of the cervical spine;
tendinitis;
arthrosis;
arthritis;
bursitis;
brachial nerve neuritis;
various anatomical anomalies;
traumatic injuries;
impingement syndrome.

These are only some of the possible diseases of the shoulder joint. The pain has a varied nature, but, most importantly, it indicates damage to this important anatomical formation.

As a result, it is of great importance to apply preventive measures from youth. And those who already suffer from diseases with obvious symptoms simply need the correct complex therapy to prevent their progression.

An important component of treatment is exercises for the shoulder joints.

Triceps press

Another option for improving the triceps of the arm.
A very effective exercise, but requires good general physical fitness. Start with shallow push-ups, gradually working your way up to the deepest possible. Contraindication: habitual shoulder dislocation.

I.P. rest your hands on the edge of the sofa, straight body, rest your heels on the floor. Push-ups with lowering the pelvis to the floor, 10–20 repetitions. Try to straighten your arms completely.

The first movements are accompanied by overcoming the dominant pain and crunching in the area of the upper limbs when stretching the pectoral muscles and muscles of the shoulder joint. Don’t be afraid of this; after 3-4 repetitions, these painful and unpleasant sensations disappear.

The exercise restores the elasticity of the muscles of the upper limbs, which, in turn, helps restore normal blood circulation in the cervicothoracic spine. This, in turn, helps get rid of pain syndromes due to osteochondrosis of the spine, pain in the shoulder joints, and also restores innervation, that is, sensitivity of the fingers.

The exercise also has a cosmetic effect, eliminating muscle wasting on the back of the arm (“farewell arms”).

By performing this exercise 2-4 times a week, you can completely restore the elasticity and strength of the muscles of the shoulder joints.

Kinesiotherapy of the shoulder joint

Special physical exercises created by Dr. Sergei Mikhailovich Bubnovsky are aimed at restoring the mobility of not only individual joints, but the entire musculoskeletal system.

The emphasis in Bubnovsky’s program for the treatment of pain in the shoulder joint is not on pharmacological drugs, but on the internal hidden reserves of the body.

Kinesiotherapy of the shoulder, that is, treatment with movement, can be used by people of all ages and with any severity of the disease. Daily practice of this simple set of exercises and a gradual increase in the number of repetitions are of great importance.

Rules of gymnastics according to the method of Dr. Bubnovsky

During an exacerbation of the disease of the shoulder joint, which can be manifested by swelling, redness, especially severe pain in the affected area, it is necessary to reduce or completely eliminate physical stress on the shoulder, that is, performing exercises.

After this period, when the pain decreases, the process of repairing the joint and muscles can slowly begin. Begin the exercises gradually, noting internal sensations. If a person feels pain and discomfort, you should not stop doing gymnastics, you need to overcome this by increasing the load. If sharp joint pain in the shoulder suddenly occurs, exercises must be temporarily stopped.

The effectiveness of kinesiotherapy for the shoulder joint is manifested by a decrease in the intensity of painful sensations, an increase in range of motion, better tolerance to physical activity and, of course, a person’s good mood.

Exercises

Gymnastics for the shoulder joints, developed by Dr. Bubnovsky, is used in specialized centers. But these exercises can easily be used for treatment at home.

Every morning, patients must do special exercises. Immediately after sleep, without getting out of bed, you need to warm up - stretch up, spread your arms to the sides, behind your head, forward. After warming up, the person gets up and does exercises. At first, 15-20 minutes of gymnastics is enough.

Dr. Bubnovsky says that only the first sessions will hurt. He advises reducing pain with a contrast shower or an ice compress on the shoulder area. It is recommended to perform all movements while exhaling, which relaxes the thoracic region and reduces blood pressure on the affected tissues. After a long time of regular exercise, relief should come.

Text of the book “Shoulder Pain, or How to Restore Mobility to Your Arms”

Sergey Bubnovsky Shoulder pain, or How to restore mobility to your arms

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Introduction

Functional antalgic contractures of the shoulder joint after a clavicle fracture, damage to the muscles and tendons of the shoulder, habitual dislocation of the shoulder or frozen shoulder, tennis player's elbow, osteoporotic wrist fractures - how to restore the functionality of the arm with such problems if you are over 60–70 years old? But even young people who are involved in sports that are overly aggressive for the musculoskeletal system (such as crossfit, alpine skiing in various forms, martial arts and others) very often receive injuries to the upper extremities, sometimes leading to disability.

This topic is very difficult to explain, because the restoration of these joints, especially after injuries and excessive surgical influences, requires a lot of time, enormous patience and a clear sequence in rehabilitation actions, moreover, without knowledge of the functionality of biomechanics and an understanding of the basic laws and methods of modern kinesitherapy these problems are critically insoluble. But if young people with similar injuries are sufficiently motivated to apply aggressive methods of physical rehabilitation to them, then older people who, in addition to these problems, have a whole bunch of concomitant diseases, have a very difficult time.

But what to do? How to carry bags from the store, put on clothes, brush your teeth and prepare food if your shoulder, elbow or hand don’t work? These and many other problems associated with injuries and diseases of the joints of the upper limb are discussed in this book. The book also touches on pressing topics about pain in the cervical spine, which most neurologists and neurosurgeons associate with degenerative changes in the intervertebral discs - hernias and protrusions of the spine. But is this so, or are the problems completely different?..

Read! You will find it interesting and extremely educational! Remember that surgeons do not restore health - they save lives and cut off everything that has been used up. How to live further? This is what we will talk about in this book.

The causes of damage or disease to elements, parts or joints of the musculoskeletal system can be various factors: tumor, infection, dystrophy, injuries (direct and indirect). In such cases, there is a need to provide specialized medical care both at the stage of exacerbation and at the stage of the chronic course of the disease. As a rule, during an exacerbation, acute pain persists for up to 3–6 days (this period is conditional, since much depends on the psyche of the victim - some may demonstrate acute pain for quite a long time). The chronic course of the disease can be called a prolonged exacerbation (conditionally more than two weeks).

If the illness lasts more than four months, you can contact the Medical Labor Expert Commission (VTEK) to obtain disability (initially temporary - for 1 year). In practice, the main role in diagnosing diseases of the musculoskeletal system is played by neurologists or neuropathologists, who consider their medical discipline to be the main one for disorders of movement, sensitivity, coordination and other symptoms. These doctors consider neurology one of the most logical disciplines, and it was with their “light hand” that symptomatic medicine was introduced, in which one complaint can correspond to various diseases, although previously they considered it necessary (and still believe) when examining a patient to simultaneously study not only anatomy -physiological aspect, but also topical - a set of syndromes, which in turn are composed of various symptoms-complaints.

But even in this case, when examining a patient, it is necessary to realize that similar topical syndromes can develop in various pathological processes - vascular, tumor, inflammatory, traumatic, etc. Therefore, when diagnosing, collecting an anamnesis (medical history) and analyzing additional studies is very important: blood, MRI and others. Based on this analysis, a diagnosis is made, which identifies the disease and determines the treatment option. And here everything happens in a very ambiguous way.

The main belief of neurologists is that the human brain is the most highly organized matter on planet Earth, and all other organs and systems of the human body are designed to serve the brain! If there is no brain, there is no person. It would seem difficult to object to this?! Loss of a nerve means paralysis of an arm, leg, or body.

The brain really controls everything! But to serve is to help! And without organs that feed the brain, our human brain is not needed: what is it for if there is no body? According to this theory, the musculoskeletal system moves the brain around the planet, and that’s all... This is such an arrogant model of attitude towards human health! On the one hand, neurology, which assigns a pejorative secondary role to other organs and systems of the body: respiration, immunity, gastrointestinal tract, musculoskeletal and cardiovascular systems, and on the other hand, all other specialists. But without any of these organ systems, the brain will not be able to function, because, according to the same neurologists, they feed the brain. Despite this, symptomatic medicine has appeared: a cardiologist is responsible for the cardiovascular system, a dermatologist for the skin, a pulmonologist for the bronchopulmonary system, etc.

And although in the prenatal period the nervous system is formed and develops earlier and faster than other organs and systems, nevertheless, the formation and development of other organs and systems proceed synchronously (!) with the development of certain structures of the nervous system! The outstanding Russian physiologist P.K. Anokhin called this process systemogenesis, that is, simultaneous functional maturation and interaction of dissimilar organs and structures. This functional maturation and development of the organism (morphogenesis) also occurs in the postnatal period (that is, after the birth of a person). And the development of the brain in this process (morphogenesis) depends entirely on the systems that feed it – the cerebrospinal fluid and circulatory systems!

The question arises: who bears the function of transporting cerebrospinal fluid and blood to the brain? There is only one answer: it is the muscular system, which makes up on average 60% of the body! Yes, of course, the muscular system is controlled by the brain (CNS), but exclusively through the corticomuscular pathway (neuromuscular). This is an axiom. The vessels that supply the brain with blood run inside the muscles, and the brain, which does not have its own muscles, is a machine without gasoline, so it itself is entirely dependent on the muscles that it controls.

But neurologists in the treatment and rehabilitation process do not recognize muscles as a healing factor - it’s too simple... Tapping with a hammer, pricking with a needle in order for the muscles to react to these influences - this is possible. But what next: prescribe the patient treatment with blockades and hormones in order to relieve the pain? But it is precisely the interruption of the neuromuscular pathway that can lead (and often leads) to secondary paralysis and muscle atrophy! So what does neurology stand for when the shoulder, elbow or wrist is not working well? Yes, of course: it is necessary to determine the lesion! But something else often happens. In some diseases, it is impossible to explain the entire disease picture (clinic) by one or two pathological foci in the brain, despite the availability of blood test results and MRI of the brain and spinal cord. For example, in multiple sclerosis, parkinsonism and other degenerative diseases, the causes of the disease can be vascular, tumor, inflammatory, traumatic processes, etc. And although the medical history data can be quite detailed (for example, in neurology), specialists most often There is not enough information about the patient’s lifestyle. But how can we objectively collect such data if every specialist is pulling the blanket on himself?

In psychiatry, S. Freud introduced the concept of psychoanalysis, that is, the history of the patient’s life, which led the latter to a doctor - a psychiatrist or psychotherapist. In modern kinesitherapy, in addition to the mandatory collection of anamnesis (CT, MRI, blood tests), new diagnostic methods have been introduced into practice that create a fairly objective history of the development of the disease or injury. These are myofascial diagnostics (examination of all muscle groups and joints) and functional muscular diagnostics (monitoring the strength endurance of muscle groups (synergists). These two types of diagnostics are not subject to existing diagnostic devices (CT, MRI). True, there is also myography, but there is no clear picture of the depth It still does not cause damage, since the sensors are installed on the surface of the skin.

We also created a device that we called a myofasciograph, but few specialists can understand its graphs - the results of a diagnostic study using this device. These three types of myofascial diagnostics are tied to the Bubnovsky medical simulator and provide a fairly holistic picture of disorders in the musculoskeletal system of patients. Such diagnostic methods make it possible to create a program for the treatment of pain syndromes or rehabilitation without the use of painkillers, anti-inflammatory drugs (NSAIDs) for each patient, taking into account his individual characteristics and concomitant diseases. But for this you need to have deep knowledge in the field of natural (drug-free) therapy.

It is necessary to realize that the nervous system arises and develops in the process of interaction of the body with the external environment; it is devoid of rigid stability and changes, continuously improving in the processes of the body’s vital activity (as in the song: the sun, air and water are our best friends!). These properties appear when there is pain in the joints or back: due to the fact that the nervous system has adaptation, it can acquire new functions that can be consolidated! For example, with acute pain in the lumbar region, a return to a lower level of phylogenetic development often occurs: the patient cannot walk upright, but can move on all fours. In this case, the control of the legs by the cerebral cortex, the youngest parts of the nervous system, seems to be turned off. They taught a man to walk and... forgot how? After a certain period of moving on all fours (the person temporarily became a child who cannot walk), the brain again remembers the mechanism of vertical walking, turns on its corticospinal (neuromuscular) pathway, and after some time the patient “verticalizes.” At such a point in the illness, it is NSAIDs that interfere with the restoration of walking, and even more so blockades in the paravertebral tissues. These so-called “medicinal” drugs disrupt the passage of nerve impulses and promote atrophy of nerve endings that carry information along a complex system of nerve pathways.

Nerve cells have the ability to perceive, conduct and transmit nerve impulses, but this requires a high intensity of metabolism taking place in the capillaries. Therefore, they need a constant supply of oxygen, glucose and other substances. In this regard, even in the acute stage of the disease, and even more so in the chronic stage, a decrease in general and partial motor activity, and even against the background of painkillers or anti-inflammatory drugs, has a detrimental effect on the regeneration processes of neuromuscular connections. When using active motor therapy (kinesitherapy) for various “losses” of nerve impulses, interaction occurs between ascending (afferent) and descending nerve conductors, the situation is “analyzed” by the brain, and a command is sent to the executive organs - striated muscles, endocrine organs, internal authorities – like “do as ordered.” And the organs perform. But this requires constant movement of blood and lymph! As they say, water does not flow under a lying stone!

It is important to understand that only the force created by a tensed muscle can excite the receptors of nerve cells (motoneurons), and this force must be significant. That is, the movements of the arms and legs themselves, as is done in exercise therapy, are unable to excite the motor neurons of the spinal cord to transmit information to the brain - such efforts can be created and controlled only on simulators of local and narrow-local action.

For a rehabilitation program, it is necessary to understand that the same muscles are involved in providing different movements, but with different strength and speed. Regulations for connecting the necessary muscles (muscle groups) in kinesitherapy are drawn up on the basis of an analysis of myofascial diagnostics and functional muscle testing. But the motor act itself is formed as a result of a sequential, that is, gradual, consistent in strength and duration, activation of individual neurons of the cortical-muscular pathway, which gives orders to the muscles, and a large complex of nervous structures, between which there are numerous bilateral connections (closed neural circles).

Almost all sensory and motor nerve fibers have collateral connections, that is, a kind of doubles: if one does not work, you can turn on the other. This is the basis of P. Anokhin’s theory of functional systems, which allows one to recreate regenerative processes even in a seemingly dead nerve! To do this, you need to force the body (or limb, or spine) to engage in movement. In nature, it is possible to pump water into a dry stream from a neighboring stream, and the same replacement can be recreated in the human body.

Why such a long preamble? Only in order to evaluate subsequent methods for restoring sensitivity and strength of the upper limb when its joints are affected. I will talk only about the most common syndromes, since similar disorders are restored according to the same rules, taking into account the individual characteristics of each patient. But all these joint problems are dystrophic, inflammatory or traumatic in nature (including conditions after surgical interventions). Damage to the elements of the cerebrum and spinal cord (myelopathy) is not considered in this section, although in such cases, for a certain motor compensation, it is necessary to follow the path of modern kinesitherapy. Restoration of the motor system, even partial, is possible only through the right exercises.

Shoulders - a tool of the brain

Have you ever thought, for example, about why a person needs shoulders, or, as anatomists say, a shoulder girdle? Should I wear a jacket or a sweater? But few people know about the main functions that are assigned to the shoulder girdle and the implementation of which should be mandatory for a person of any gender and age. I often ask my patients who complain, in particular, of headaches: “How long have you done pull-ups on the horizontal bar?” In response, a puzzled look that reads: “Why do I need this?” Then I ask the following question: “Why does a person need back muscles, which by nature are designed for pull-ups?” Or another: “If muscles are not used, what happens to them?” Everyone always answers: “They are atrophying.” They know it and... they don’t use it. Of course, I can name any other exercises in which the muscles of the shoulder girdle are actively involved and which these people also do not perform, although they should be performed regularly, as a matter of course. Practice shows that those who regularly perform these and similar exercises do not suffer from headaches.

So, one of the most important areas of the body is the shoulder girdle and the associated arms and cervical spine. The shoulder girdle consists of four regions: scapular, subclavian, axillary, deltoid.

Regions are not just one zone. For example, the axillary region is not only, as people say, an armpit. This is a system of muscles, tendons, fascia, within which arteries, veins, and lymphatic vessels pass.

Doctors, by the word “region,” unlike anatomists, designate only a zone of the body for external orientation. For example, the injection site. Or the location of the boil. If you simply say “boil on the shoulder girdle,” it is difficult to know where to look: under the armpit or under the shoulder blade. Therefore, anatomical education is necessary. Everyone should understand their body and the functions of each of its parts. I believe that the ability to use, for example, the muscles of the shoulder girdle can prevent the development of severe diseases that no medicine can ever cope with, namely headaches. In life, as it happens, hands go up, and thank God. But there are other situations. A man woke up, but couldn’t raise his hand. Without any injury or external cause. The man was just sleeping, doing nothing. Someone will say: “I probably lost my hand. Did you sleep on one side? But why, at the age of 20, could this same person lie on one side all night and wake up healthy? And at the age of 40, suddenly your arm lays down and it doesn’t rise?

Functional anatomy of the shoulder

It is better to begin to disassemble the shoulder girdle by understanding the structure of the shoulder joint, around which the entire girdle is built and which is more often than other elements of this zone subject to household and sports injuries. The difficulty of restoring and treating the shoulder joint lies in the fact that even experienced traumatologists who use pain-relieving blockades in their arsenal of treatments do not fully understand the complexity and uniqueness of this joint, forgetting its muscular structure. That is, any immobilization (immobility) or blockade that eliminates muscle sensitivity during movement causes irreparable damage to the shoulder, as it contributes to the atrophy of these muscles. Apart from shoulder injuries associated with ruptures and fractures, any inflammation resulting from unsuccessful efforts must be treated with movement. It is characteristic, however, that most manifestations of the disease are associated precisely with “hand movements” at an average age of 40 years. At this age, joint pain is often perceived as natural, and people prefer to move their arm less so as not to cause pain. The result of such a limitation is, as radiologists write in their conclusions, “calcareous deposits in the degenerative tendons of the rotator muscles of the shoulder, adhesions or adhesive capsulitis of the walls of the duplication cavity of the lower recess with breakthrough of deposits into the subacromial bursa.” Translated into normal language, this means that in the event of a sharp decrease in joint mobility, all its cavities become overgrown with salt crystals and the elasticity of the muscles is replaced by stiffness. At the same time, in the specialized literature, when describing glenohumeral periarthritis (inflammation of the soft tissues surrounding the shoulder joint) in the stage of a “frozen” or “frozen” shoulder, one can find the following formulation: “The shoulder joint, which functions daily with a full range of movements, does not freeze.” Then what to do if the pain when moving your hand is unbearable and can even lead to loss of consciousness?

When considering clinical options for damage to extra-articular soft tissues of the shoulder joint, they can be divided into primary

(diseases of the tendon-ligamentous apparatus, the predominant group of which is PLP, or painful shoulder syndrome), and
secondary
, observed, for example, in rheumatic processes (rheumatoid arthritis, spinal osteochondrosis, etc.).

When treating joint diseases, I was always interested only in the cause of the lesion - the primary one. Likewise, I consider PLP not only as the most extensive pathology of the shoulder girdle, but also as a trigger model for damage to the myofascial tissues of the PVC. Therefore, the emphasis on the girdle of the upper extremities, its muscular system, which tones the blood vessels of the brain, and therefore nourishes the brain, is not accidental. But the average person is still lazy. And he is always looking for some reason to evade the need to do gymnastics. Therefore, when glenohumeral periarthritis appears, accompanied by pain in the arm when moving, for some reason they are happy when the doctor forbids making these movements. What happens? Today, a person does not fully raise his arm, and a frozen shoulder develops. But the vessels that are part of the systemic circulation and located in close proximity to the vascular network of the brain also freeze in the shoulder. The flow of fresh blood to the brain decreases, venous outflow of blood worsens with increased intracranial pressure, and atrophy of brain segments occurs. So we, imperceptibly from banal pain in the shoulder, which caused restrictions in its movement, came to brain atrophy, that is, dementia. So what can you do to prevent this from happening? There are no muscles inside the brain. Therefore, let's start treating glenohumeral periarthritis, by eliminating which we will restore nutrition to the brain, thereby preventing its atrophy.

How to understand this? Yes, very simple. For example, you wanted to do pull-ups on the bar. But you have to grab onto it. The muscles of the hands are used for this. There are two groups of them: the palmar surface (10 muscles) and the dorsal surface (4 muscles). Someone might wonder: “What does a brush have to do with it?” Then show me a person who can hang from a bar without using a hand (it's not funny). But the nerves for controlling the muscles of the hand come from the area of the upper cervical vertebrae through the area of the shoulder joint. Let's rise higher. Forearm muscles. There are several layers of them. Moreover, there are anterior and posterior muscle groups. The anterior group of muscles of the forearm - 10 muscles - bends and rotates the fingers, hand and forearm itself. The posterior group of muscles - 8 muscles - extends, rotates, abducts the hand, fingers and forearm. In addition, these same muscles bend the arm at the elbow joint.

All of these 18 forearm muscles are controlled by the same nerves that emerge from the cervical spine. With this I want to emphasize the direct connection between the fingers and the cervical spine. Next, that is, after the forearm, we meet the muscles of the shoulder (flexors-extensors). There are five of them. These muscles flex and extend the arm at the elbow joint, and the coracobrachialis muscle, one of them, also raises the arm. Higher. Here we meet the muscles of the shoulder girdle - there is also such a group of muscles. There are 6 of them. But, perhaps, the main problem for the shoulder joint is five of them. These are deep, short muscles. They are called rotators, or shoulder rotators. It is when they are injured that the main pain occurs when rotating the shoulder joint and moving the arm to the side. One of the most dangerous diseases in this case is frozen shoulder syndrome. Typically, such people are helped to take off and put on shirts, not to mention trying to fasten a bra (for women), and men become helpless when trying to put a bag in the overhead bin on a plane or train. I had a patient with frozen shoulders, an auto mechanic. Can you imagine him in a hole under a car that he has to repair, but he is unable to raise his arms above his waist? I have had violinists who were unable to hold the instrument. Hairdressers, cosmetologists, painters... I will return to a more detailed description of shoulder disease and treatment methods a little later. Now I want to continue the anatomical investigation of the functioning of the hand, or, as doctors say, the upper limb. So, on one hand alone we counted 33 muscles. But in order to pull yourself up on the bar, these muscles are not enough. For this action, you also need to connect the back muscles. There are thirty-one of them. This muscle group consists of the superficial, deep and short back muscles. There is no need to list them; besides, almost all athletes know the superficial muscles. These include the trapezius, latissimus, rhomboid, and serratus muscles. Of the deep muscles, the most famous muscle is the rectus abdominis muscle. And of the short muscles - interspinous and intertransverse.

But that's not all muscles. There is an equally important group of antagonist muscles of the back - the chest muscles. There are four of them. The most famous of them are the pectoralis minor and major muscles.

So, let us summarize the first results of the anatomical investigation of the movement of the arm in the shoulder joint. We counted 68 muscles on only one side of the body, and humans have two of them: right and left. Therefore, in order to do a pull-up on the horizontal bar, push-ups from the floor, or throw a suitcase onto the top shelf, you need to use 136 muscles, all at the same time.

This is primarily due to the fact that, unlike other joints of the body, the shoulder joint is muscular. That is, the main cause of shoulder pain is injuries (sprains, bruises) to the deep muscles of the shoulder joint (rotators), which is why the joint becomes very painful with any movement of the arm. And doctors, primarily traumatologists, as practice shows, look for the cause of pain in the shoulder in its bone structure, drawing their conclusions based on X-rays (ultrasound or MRI). But it is known that deep rotators of the shoulder joint are not reflected in any of these diagnostic examinations, except to some extent on ultrasound. The reason for this is that muscles are structurally made of water. Just in case, wearing fixing bandages is prescribed and any loads are prohibited. Atrophy of these muscles occurs, which always occurs during immobilization, which can lead to habitual dislocation. I lifted the heavier bag and my hand hung.

I was also interested to learn that the shoulder joint consists of five joints! Yes Yes! This is described in every decent anatomical reference book. But three out of five are true, that is, they contain articular surfaces: the glenohumeral joint, the sternoclavicular joint, the acromioclavicular joint. And they are formed by five bones: the humerus, scapula, sternum, clavicle and acromion.

Two are pseudo-joints: the bursal joint (humeral-acromial) and the so-called movement of the scapula along the chest wall. These two joints do not have independent articular surfaces. But the most interesting thing is that none of them can be considered separately, like, for example, the joints of the fingers. All these seemingly separate joints participate in the work of one joint, the shoulder, which unites them. The shoulder joint is the most mobile joint in the body. Its mobility is characterized by the following capabilities: abduction-adduction of the arm. But that's not all.

During my long medical practice, I have never seen a medical report for a patient with glenohumeral periarthritis or frozen shoulder syndrome that mentioned at least five main rotators of the shoulder, without which movement in the shoulder joint is impossible in principle, not to mention 136 muscles. At the same time, patients turned to me for help after long-term unsuccessful treatment of shoulder pain with non-steroidal anti-inflammatory drugs (NSAIDs), hardware physiotherapy, acupuncture, and some of them even after arthroscopy. There were also those who did not experience acute pain in the shoulder, but could not lift the suitcase onto the top shelf, much less pull themselves up on the bar. How to use these muscles to treat the shoulder joint, what exercises and loads to use for this, I will tell you a little later, in a special chapter. Now I would like to draw the reader’s attention to the fact that very often shoulder pain is accompanied by headaches. Therefore, countless times I have been able to relieve patients from headaches with the help of exercises in which the main kinematic link is the shoulder joint. Another observation is interesting. Headaches often appear on their own, seemingly out of nowhere. Therefore, when they first appear, people don’t even think about where they came from. They swallow a tablet of some aspirin - and that’s fine. This occurrence of headaches, as a rule, is not related to traumatic brain injury or hypertension. Their appearance is most often explained by banal reasons: I didn’t get enough sleep, I was nervous, for example, before an exam, I drank something unusual for myself, beer or champagne. In the future, when headaches arise again, a previously tested method is used, namely a tablet. People get so used to them that they do not complain to the doctor even when cervical osteochondrosis worsens, and now it is fashionable to talk about herniated intervertebral discs of the cervical spine or shoulder pain. Therefore, when I ask patients who come to me with similar complaints whether they suffer from headaches, they cheerfully answer: “Yes, for a long time! And already in the form of migraines.” But the fact is that headaches are vascular pains. And pain in the shoulder or cervical spine is organic pain. The only difference between them is the time of their appearance. Soft and elastic tissues suffer first. In our case, the vessels are due to the insufficient volume of blood flow that must pass through them. And then the poorly functioning bone-cartilaginous structure - the intervertebral discs, the cartilaginous surface of the joints - begins to collapse. The result is a stiff joint, in this case the shoulder, and problems in the cervical spine. Therefore, the first stage - damage to the vascular bed of the brain, manifested by headaches without seemingly an external cause - remains unnoticed against the background of drug anesthesia. Why does a person need to do pull-ups and push-ups if he earns money by sitting in a chair and looking at the monitor? It’s only later, when one day he wants to easily get up from his chair to go home, he suddenly feels a spasm, a momentary loss of consciousness, cold sweat and animal fear. What is this? Having taken the pill, he forgets about it and continues to live as if nothing had happened. The muscles of the shoulder girdle work less and less. Blood flow through the vessels decreases. But a pill taken in time eliminates this discomfort, and a visit to the doctor occurs only at the moment when several links of the kinematic chain have already fallen out. In our case - the shoulder joint, the cervical spine and the entire shoulder girdle.

Few people know that you can get rid of headaches by combining certain physical exercises that involve the muscles of the shoulder girdle, which creates a pain relief effect. None of those who wrote about their problems in the above letters even thought that it was the weakness and neglect of the muscles of the shoulder girdle that was the main reason for the appearance of chronic headaches. What do you think is better - to take psychotropic drugs that reduce the level of personality and accelerate the development of dementia, or to learn how to do physical exercises correctly?

I use this practice quite successfully. Of course, we are not talking about push-ups or pull-ups on the bar. I'm talking about MTB machine exercises, where, as I've said in previous books, the key is to use diaphragmatic breathing, which, when done correctly, reduces intracranial pressure. Namely, many neurologists explain the cause of headaches by increased intracranial pressure. What do I want to emphasize with this? What do you think is better - to accept

for many years, non-steroidal anti-inflammatory drugs, which have a monstrous number of side effects,
psychotropic drugs that reduce the level of personality and accelerate the development of dementia, or learn how to properly perform physical exercises
and at the same time get rid of not only headaches and shoulder pain, but also strengthen your psychological stability, that is, the psyche, activating the vessels that feed the BRAIN?