File:A manual of therapeutic exercise and massage, designed for the use of physicians, students and masseurs (1917) (14597720018).jpg

Identifier: manualoftherapeu00buch (find matches)
Title: A manual of therapeutic exercise and massage, designed for the use of physicians, students and masseurs
Year: 1917 (1910s)
Authors: Bucholz, C. Hermann (Carl Hermann), 1874-
Subjects: Exercise therapy Massage
Publisher: Philadelphia and New York, Lea & Febiger
Contributing Library: Harold B. Lee Library
Digitizing Sponsor: Brigham Young University

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ion of the shoulder muscles; any irritation by the exercisewill cause nmscular spasm, which represents a strict contra-indication to further exercise to the angle at which spasmtakes place. It may be that muscular spasm prevents anymotion at all, but that condition should not be confusedwith the voluntary muscular fixation. Moreover, if the treatment has been carried on with suffi-cient gentleness during the preceding days the patient is, asa rule, sufficiently trained to understand the directions ofthe operator. For the first two or three days we advisepassive exercises with the shoulder completely dropped andthe muscles relaxed, the fingers which rest on the tuberosityalways controlling so that the upper fragment moves well FRACTURES 173 with the shaft. Following these precautions it seems almostincomprehensible how any harm can be done to the point ofthe fracture. After a few days we begin to have the patient assist in themotions by his own muscles, giving rather an assistance than
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Fig. 49.—Impacted fracture of the humerus: Woman, aged sixty years.In this case exercise and massage treatment was begun three days afterthe injury, with the result that eight weeks after the injury the patienthad at least three-quarters of the motion free. Only the external rotationwas somewhat more limited, and the patient was able to do her full workas caretaker of a large house. a resistance, gradually, hoAvever, changing to the latter withincreasing strength. At the same time the angle of motionis increased gradually and movements in the other directionsare added, abduction and rotation. Further increase in motion and strength will be obtainedin a rather short time and then the technic of exercise does 174 INJURIES not (liflVr iiuicli from the common rules set for shoulderexercise. Careful handling of the arm will avoid inflamma-tion of the subacromial bursa and prevent bursitis, which isoften such a very disagreeable complication of lesions of theshoulder and more or less the

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