The Role of Physiotherapy in Managing Hill-Sachs Lesions

Arunalaya Advanced Physiotherapy and Rehabilitation in Patel Nagar, Delhi, explains the importance of physiotherapy in the management of Hill-Sachs lesions. Learn about the classification, clinical presentation, and physiotherapy interventions to prevent recurrence of shoulder dislocations. Contact us for personalized rehabilitation services.

Introduction:
Hill-Sachs lesions are osseous defects that occur in association with anterior shoulder instability or dislocation. Arunalaya Advanced Physiotherapy and Rehabilitation in Patel Nagar, Delhi, highlights the significance of physiotherapy in managing Hill-Sachs lesions. This blog post discusses the classification, clinical presentation, and physiotherapy interventions to prevent the recurrence of shoulder dislocations.

Understanding Hill-Sachs Lesions:
A Hill-Sachs lesion is characterized by a dent or defect in the postero-supero-lateral humeral head, typically caused by anterior shoulder dislocation. It occurs when the posterolateral aspect of the humeral head impacts the anterior glenoid during dislocation, leading to shoulder instability.

Epidemiology and Classification:
Hill-Sachs lesions are prevalent in cases of anterior shoulder instability, with an incidence ranging from 40% to 90%. The severity of the lesion can be classified into grades based on the depth of the defect and further categorized by the percentage of humeral head involvement.

Clinical Presentation:
Shoulder dislocation causes damage to various tissues surrounding the glenohumeral joint, resulting in pain, limited movement, and visible changes in the shoulder contour. Differential diagnosis includes Bankart lesions, pseudo-Hill-Sachs lesions, humeral avulsion fractures, and other related conditions.

Physiotherapy Management:
The primary aim of physiotherapy is to prevent the recurrence of shoulder dislocations in patients with Hill-Sachs lesions. Several key factors should be considered in the rehabilitation process:
1. Pathology onset
2. Degree and frequency of instability
3. Direction of instability
4. Concomitant pathologies
5. Neuromuscular control
6. Activity level

Stiff Sling:
Patients may require 2-6 weeks of immobilization in a mastersling to allow for ligament healing and prevent dislocation. During this phase, scapula stabilization exercises, hand-wrist-elbow exercises, and education on functional adaptations are essential. Driving should be avoided while still in the sling.

Rehabilitation Exercises:
Once the sling is discontinued under the recommendation of an orthopedic surgeon, the focus shifts to rehabilitation exercises. This includes pendulum exercises, passive, active-assisted, and active range of motion exercises. Abduction and external rotation may be initially restricted to allow for proper healing. Strengthening exercises for the deltoid, rotator cuff, and periscapular muscles (e.g., pectoralis major) are crucial for stability.

Conclusion:
Arunalaya Advanced Physiotherapy and Rehabilitation in Patel Nagar, Delhi, emphasizes the importance of physiotherapy in managing Hill-Sachs lesions and preventing shoulder dislocation recurrence. Our team of experienced professionals will provide personalized rehabilitation services tailored to your specific needs. Contact us to receive comprehensive care and guidance for optimal recovery and shoulder stability.