# Bankart Lesion Rehab: 5 Exercises to Stabilize an Unstable Shoulder ## Метаданные - **Канал:** Rehab Science - **YouTube:** https://www.youtube.com/watch?v=tCtfxPgkqV0 ## Содержание ### [0:00](https://www.youtube.com/watch?v=tCtfxPgkqV0) Segment 1 (00:00 - 05:00) In today's video, we'll be looking at five exercises for a Bangkart injury in the shoulder. So, if you've dislocated your shoulder in a forward direction and injured the front side of your labum or if you have clicking uh noises coming from a shoulder in pain, these will be exercises for you to try. If you're new to my channel, my name is Dr. Tom Walters and I'm an orthopedic physical therapist. So, again, in today's video, we're looking at rehab exercises for a bank injury. A bankar injury is one where the labreum of our shoulder which is a ring of cartilage that goes around the socket and gives stability to the shoulder joint. It's where that labreum is torn or maybe just irritated and painful. In a lot of cases this happens when somebody dislocates their shoulder especially if the ball pops forward out of the socket which is the most common direction of dislocation. The good thing to know is that in a lot of these cases, even though the labreum has been injured, if we work on strengthening uh the rotator cuff muscles and the scapular stabilizers, work on improving control around the shoulder joint, the area pain will get better and the shoulder will feel more stable. So, if that's something you are suffering from, let's go ahead and get into the first exercise. For the first exercise, we're going to work on activating and strengthening the rotator cuff muscles, but in a protected way. So, if you've uh suffered this injury recently, maybe dislocated your shoulder, this is a good place to start. So, this is called an external rotation isometric. You're going to stand next to a wall. And what you're going to do is have your arm at your side with your elbow at about 90° and you're going to be pushing the back of your hand into the wall to create an external rotation force. So, we're not going to be creating the movement. This is an isometric. So, we're squeezing the muscle. We're causing the muscles to contract which are right back here on the back side of the shoulder uh shoulder blade. So, we're going to cause those a contraction those muscles, but we'll have no movement and that's what an isometric contraction is. So, we're going to push into the wall with as much force as you can tolerate. So, if you have more than mild pain, don't push harder um than that. So, just find kind of a good force that works for you or maybe have no more than three or four out of 10 pain. You want to protect the shoulder, especially early on if you've had a dislocation. So, you're going to perform four to five reps of this and you're going to try to hold each one for 30 to 45 seconds. So, after you've done one rep, you can kind of take a break. You can spread these throughout the day as well. You don't necessarily need to do them all together. But then again, when you go in for the next one, elbow about 90°, push the back of the hand into the wall like you're trying to create this external rotation movement. When we do this, it will cause two of our rotator cuff muscles to contract. Again, on the back side of the shoulder, those muscles are called infraspinatus and tererry's minor. They're two of our four rotator cuff muscles. Okay, so that is our first exercise. It is an external rotation isometric. The next exercise is for a muscle called serrus anterior. That's one of our scapular stabilizers. It helps to stabilize our shoulder as we reach overhead. This muscle runs from our shoulder blade around to our ribs. And so we're going to do an exercise called the serratus wall slide. So you're going to be next to the wall again. You're going to put both arms at about shoulder level. And you've got to figure out your spacing from the wall. Your feet are going to be out just a little bit. And then what we're going to do here is protract your shoulder blades. You're thinking about kind of having your shoulder blades move forward around your rib cage. This is one of the actions of serrus anterior. So you're going to protract your scapula and then you're going to keep that position and slide your arms up the wall. So we're engaging the serrus anterior muscle while also reaching overhead. So this is just a nice way to start activating and strengthening serrus anterior but also protecting the shoulder joint, especially if we've had a dislocation recently. So you're just going to go up and down like that, keeping that pressure. You're thinking about pushing your forearms into the wall. So, pushing into the wall and then sliding up to where a comfortable range of motion for you and then back down to the starting position. Make sure you recheck. Make sure you're holding that protraction position. And you're going to think about three sets of 10 to 15 reps of this. Just going up and down like that and keeping activity in that serrus anterior muscle. Okay. So, that is our second exercise. Our third exercise is called sidelineing external rotation. like the isometric against the wall. We're going to work similar muscles, but now we're going to be moving dynamically. When you're first starting this exercise, I would encourage you to do it without a dumbbell. Just use arm weight and kind of just figure out how you feel with the movement. Even just lifting your arm will start with will start strengthening um when you're in those acute stages of healing. You're going to want a hand towel for this. You're going to roll it up. So, I'm going to lie on my opposite side. So, I'm pretending like my left arm is injured in all of these videos. So, I'm going to lie down on my right side. The towel roll will go in between my elbow and my side. And that just helps keep my shoulder in a neutral position throughout the movement. Now, what I'm ### [5:00](https://www.youtube.com/watch?v=tCtfxPgkqV0&t=300s) Segment 2 (05:00 - 10:00) going to do is start with my hand down by my stomach. Kind of rest your head here. And then you're just going to go through a dynamic external rotation. You can see here that because of how I'm positioned, gravity wants to pull my arm down. So those external rotator muscles have to work against gravity to lift my arm, which will create some degree of strengthening. So you're going to think about for this exercise going for three sets of 10 to 15 reps and going through as much range of motion as you can. If you hit a point where it hurts, that's okay. Just stop there. Or if you get a feeling like your shoulder wants to dislocate, then just stop at that point. And as the area heals, you should feel more stable. Now, if you can do 15 reps with this, three sets, 15 reps, no problem. Then you want to start adding a dumbbell. And it doesn't have to be real heavy. I've got two and a half pounds here. Usually somewhere between 1 lb to 5 lb works well. And the same movement. We're just adding a little bit of external resistance. And again, thinking about our three sets of 10 to 15 repetitions. Like the wall isometric. This is going to strengthen primarily infraspanatus and tererry's minor, two of our posterior rotator cuff muscles that are extremely important in terms of giving stability to the shoulder joint. Okay, so that is our third exercise. All right, our fourth exercise is called a quadriped weight shift. This is going to be our first closed chain exercise. So that means we're going to be putting our weight over our arm. Our hands will be fixed to the ground. So, this is a great one for working on strength and stability around the uh shoulder joint. So, causing lots of muscles to contract to provide us with joint stability. So, what you're going to do, again, I'm pretending like my left side is the side that has this injury. I'm going to go up onto my hands and knees so that I've got force over all four limbs. And then what I'm going to do is just gently um kind of set my shoulder blades. So, think about full retraction, full protraction. I'm going to find a spot right in between. And then I'm going to kind of try to stabilize my shoulder joint right in that position. And then I'm going to slowly shift my weight over my injured side. So again, I'm thinking about my left side. It's okay to do it uh over both sides, but what you're really thinking about is that injured side, putting weight over that shoulder, and just training all of those muscles around the shoulder joint to contract and hold the ball centered in the socket. So again, bank card injuries are usually from shoulder dislocations where the ball shifts out of the socket and injures the labum. So we want to incorporate exercises that teach our scapular muscles and shoulder muscles to hold the ball centered in the socket so that we stop putting stress on the injured labum and so that we're less likely to have a laboral tear again in the future. So just think about shifting back and forth like this 10 to 15 times. And again, think about somewhere around two to three sets each day. Typically, you can perform all of these exercises each day, unless things are sore, then you could switch and take a day off and go every other day. Okay, so that is our fourth exercise, which is a quadriped weight shift. Our last exercise is another close chain exercise. So, we will have our hands fixed. This is going to be a uh countertop or chair serratus push-up plus. So, we're going to be working that serrus anterior muscle like we did before on the walls slided at the beginning of the video, but this is going to be a little bit more challenging version. So, you can start against a wall if this version feels too challenging. But what you're do is looking for the back of a chair or a countertop if you need something a little bit higher. You're going to get into push-up position. And what we're going to do here is thinking about we're going to be thinking about that protraction movement we were doing earlier against the [clears throat] wall. So, this chair I've got here isn't ideal because it moves. So, don't pick something like this. You want something nice and stable. But what you're going to do is kind of put your shoulder blades down. Make sure they're not coming up by your ears. So, kind of tuck your shoulder blades down. And then you're going to work on protracting. So, you can see my elbows are not bending. Sometimes people want to try and bend their elbows and do a push-up. That's not what we're doing here. We're just doing a scapular plus. So, my shoulder blades are protracting and going around my rib cage and then they're going back. So the serrus anterior muscle helps to control and create this movement. It's not coming from like my pecs or my triceps like in a traditional push-up. So I'm just going in and out like that. It does take a little bit of practice to learn this. Sometimes people have a hard time coordinating this movement at first. So don't give up if you can't get it right away. You're just thinking about keeping your elbows straight and letting your shoulder blades slide around your rib cage. So protract and then control the eccentric into retraction and then protract again. Okay, so for this one, like the other strengthening exercises, think about three sets of 10 to 15 repetitions and try to perform this every day. Thanks for checking out today's video. I hope these exercises help you. If you need a more comprehensive program for shoulder ### [10:00](https://www.youtube.com/watch?v=tCtfxPgkqV0&t=600s) Segment 3 (10:00 - 11:00) instability or a laboral tear in your shoulder, I'd encourage you to check out my book and my app. In the shoulder chapter in my book, you'll find this laboral tear and shoulder dislocation program. in the shoulder chapter. It starts on page 204. This program, like all the programs in the book, will guide you through three phases of rehab and have pictures of me doing the exercises. These programs are much more comprehensive than a YouTube video. They're more similar to what you'd get if you came to see me in the physical therapy clinic. So, the book is a great DIY resource. I also have an app. So, if you'd like to have all of the exercises in video form, my app has programs for the entire body. And if we scroll down to the shoulder section and then over you'll find this shoulder instability program again for laboral tears and dislocations. All of the phases are um it's broken into three phases like the book, but again all of the exercises are in video form so you can click in and watch how to perform the exercise. The other really cool thing about the app is that every week I host office hours. So you can come in and on Zoom can talk directly with me and ask your personal injury and pain questions. So you essentially can get a much more personalized rehab experience. If you'd like to check out either of these resources, I will put links for them down in the description. Thanks again for watching today's video. I'll see you in the next one. Bye. --- *Источник: https://ekstraktznaniy.ru/video/43032*