The following program is for patients with glenohumeral instability who have either had an acute dislocation or chronic instability that is initially being treated nonsurgically. The important factors that will influence the success of the rehabilitation program include:
Past medical history,
Acute versus chronic condition,
Activity level,
Direction of instability,
Traumatic versus atraumatic etiology, and
Age.
In general, young, active patients with a 1st time dislocation may have up to a 90% risk of recurrent dislocations. Studies at West Point have shown nearly a 100% risk of recurrent dislocations in their high demand patient population. Early arthroscopic repair may be the best option for these patients in order to reduce the future morbidity associated with repeat shoulder dislocations. The following Rehab Protocol should be used for patients who decide NOT to have surgery after their 1st dislocation or for those who have chronic instability.

Patients with chronic instability should begin with Phase II. The use of a sling in Phase I is controversial. A prospective randomized study evaluating the utility of immobilization after an acute dislocation does not exist in the literature. The studies that do exist do not show a definitive reduction in recurrent instability for patients who do use a sling. Nevertheless, patients are more comfortable with a sling and therefore should use one until acute symptoms improve.

PHASE I (2-4 weeks)
Use a sling for 2-4 weeks (FOR COMFORT ONLY).
Cryotherapy 10-20 minutes 3-4 times daily for pain control and inflammation.
Nonsteroidal anti-inflammatory drugs (NSAIDs) and modalities such as high voltage electrical stimulation and/or ultrasound.
Codmans type pendulum exercises.
Submaximal isometric contraction exercises.
PHASE II
Passive, active-assisted, and active range of motion exercises avoiding the positions of apprehension which include combined abduction and external rotation for patients with anterior instability.
Continue cryotherapy after exercise sessions
Concentric tubing exercises for rotator cuff and scapular stabilization in addition to the isometric exercises.
Postural exercises.
Begin dynamic muscular stabilization exercises (Proprioceptive Neuro Feedback- PNF).
PHASE III
Obtain full range of motion with minimal apprehension in all directions.
Progressive strengthening with concentric weighted activities.
Continued dynamic muscle stabilization exercises.
PHASE IV
Isokinetic strength evaluation. Continued focus on strengthening in areas where weakness is noted.
Sport specific functional progression such as a throwing progression program.
Return to full sports activities as the patient is able to go through an entire functional progression program without pain or apprehension.

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DOWSING WITH YOUR SIXTH SENSE
Dowsing is a skill that anyone can learn. Its the process of using a tool such as a pendulum, rod, or even your keys or necklace to discover things that cannot be discovered using our everyday senses. It allows us to access information not available to our senses through contact with our subconscious mind. Its fine tuning your 6th sense, your intuition. It is a term that in the past has been associated primarily with the finding of water sources. Modern dowsers, or diviners as they are sometimes known as, dowse for oil gas, minerals, water, lost objects, and lost people to name just a few. A pendulum can also be used to determine ones state of health and whether particular medicines, supplements, food, etc should be taken. One can also dowse for health-care services, identify environmental stressors, find or create healing spaces, and locate a safe place to place our bed or working area. Its a great tool for self-healing that anyone can use.
Tina is a Holistic Practitioner, Speaker Teacher. Tina is certified in Hypnotherapy through the Arizona Society for Professional Hypnosis as well as the American Board of Hypnotherapy. Her modalities also include Shamanic practices, Reiki, Ear Coning, Meditation, Life Coaching, Emotional Freedom Techniques, Spiritual/Angel Readings, Crystal and Sound Healing, etc. She also holds a graduate degree. Alternative healing can be traced in Tinas ancestry for many generations. She has also studied under many spiritual leaders. Her passion to help people heal spiritually, physically, mentally and emotionally is innate in her total being. She is the Co-Founder of the School of Enlightenment and teaches classes around the valley, the USA internationally.
Please check my website for upcoming classes, free seminars, products: www.TinaSacchi.

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