Rehabilitation Guide

Unilateral arm amputees often experience conditions such as epicondylitis (tennis elbow), tenosynovitis (inflammation of the synovium surrounding a tendon) and shoulder impingement (pain caused by connective tissue rubbing repetitively against the shoulder blade) (Jones & Davidson, 1999). Common muscles injured are the pollicus longus tendons and flexor tendons of the wrist, the rotator cuff muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) in the shoulder, and the abductor tendon, abductor pollicus and abductor longus of the arm (with pain running down the epicondyle) (Jones & Davidson, 1999). Each of these injuries can occur to the remaining limb or the unaffected limb. Many patients will use their full limb to compensate for the decreased functionality of the amputated limb. These injuries are painful and can become debilitating if left untreated. A simple rehabilitation program can help maintain the strength of the muscles at risk and prevent overuse that leads to prosthetic abandonment.

The first step to using this rehabilitation program is to identify where in the body the user is experiencing weakness and pain. Any user would benefit from performing all or a few of these exercises. Generally speaking, the muscles, tendons and ligaments of the body are all interconnected, and weakness in one area will generate pain or weakness in others. This is termed 'referred pain,' and is often the first sign of an overuse injury. The simplest way to identify what exercises are right for the user is to identify the area where there is notable pain or weakness. For example, if the user is feeling pain through the elbow, then start with the shoulder and elbow exercises below. Both categories of exercises will address overuse, even if the pain is referred to the elbow from the shoulder. These exercises can be done every day or as tolerable. Two sets of ten repetitions of each exercise is a sufficient amount to begin rebuilding strength in the muscles, and can be increased as the user progresses.