Use of Active Release Techniques in the Postoperative Shoulder: A Case Report

Dale J. Buchberger, DC, DACBSP

Abstract:

Much information has been published regarding rehabilitation of the postoperative shoulder in both the athletic and general populations. Little, however addresses the importance of manual soft tissue techniques as part of the postoperative management, the major focus of which is active strength and flexibility exercises. This article reports on the practical application and benefits of adding Active Release Techniques Soft Tissue Management System to the rehabilitation of the postoperative shoulder. The case presented is that of a male athlete who had an anterior dislocation of the glenohumeral joint during a motorcycle accident. Two years after undergoing a Bankart procedure for stabilization, he presented with pain, limited range of motion, and weakness in the affected shoulder. Isokinetic evaluation correlated with the physical examination findings of a postoperative strength deficit during internal rotation of the humerus. Active Release Techniques Soft Tissue Management System was applied twice weekly for 2 weeks. The patient was instructed not to alter his daily routine, and no additional rehabilitation was instituted other than the specified regiment of Active Release Techniques. A follow-up isokinetic test displayed a reduction of the initial internal rotation deficit from 28.4% to 3.6% at 120 per second, 11.9% to 1.8% at 180 per second, and from 9.0% to 6.2% at 300 per second. The results seen in this case report warrant larger clinical trials of the Active Release Techniques in the postoperative management of the shoulder and the author recommends their inclusion as a standard application in the rehabilitation of the postoperative shoulder.