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1 4 . H O W T O U S E T H E W I R E L E S S P R O F E S S I O N A L O N S P E C I F I C
I N D I C AT I O N S
235 EN WIRELESS PROFESSIONAL
14.8.2 Shoulder instabilities
Shoulder instabilities are one of the most common pathologies, and their treatment remains a difficult
challenge.
Trauma, repeated microtraumas or a constitutional laxity can compromise the stability of the shoulder
either by injuring the passive structures (distension or tear of the inferior glenohumeral ligament,
detachment of the labrum, progressive stretching of the capsule, etc.) or by disturbing the motor systems,
causing a reduction in the coordination component resulting from the action of the scapular and
scapulohumeral muscles.
The supra- and infraspinous muscles are the main coordination muscles of the glenohumeral joint;
however, their efficacy is reinforced by the tone and muscle mass of the deltoid.
Unlike in the rehabilitation of rotator cuff tendinopathy, in which the work of the deltoid must be
prescribed due to the subacromial interference, combined muscular electrostimulation of the deltoid
and the supra- and infraspinous muscles is beneficial in this case because it allows for the stabilising
musculature of the shoulder to be optimised.
14.8.2.1 Protocol
Phase 1: Disuse atrophy Level 1 until full, painless mobility is obtained
Phase 2: Disuse atrophy Level 2 until there is no pain during physical examination
Phase 3: Disuse atrophy Level 2 (+ mi-ACTION mode). Stimulation of of the infra- and supraspinous
muscles combined with voluntary proprioception exercises until the recovery of strength and
endurance corresponding to functional requirements.
14.8.2.2 treatment frequency
Three to five sessions per week.