Gymnastics for the treatment of shoulder pain. Shoulder-shoulder periarthritis

Pain in shoulder joint characteristic of different age categories of people. Often, such a symptom manifests itself in old age, but it can also occur in young children who lead an inactive lifestyle. Depending on the etiological factors pain can be different character and force of influence.

The shoulder joint hurts primarily because violations have occurred in its structure. To eliminate discomfort and discomfort in the patient, the doctor needs to identify the causes of joint damage and act on the source of the symptom.

Etiology

Pain in the shoulder joint of the right or left arm various reasons formations. Often unpleasant symptom manifested under the influence of such etiological factors:

sedentary lifestyle;
broken posture;
joint injuries;
age - more than 50 years;
infectious diseases.

The causes of pain in the shoulder joint also lie in some pathologies:

joint damage;
brachial nerve;
neoplasms;
calcification of connections.

Other pathologies can also provoke inflammatory actions in the shoulder joint. internal organs, which are characterized by the same symptom. These include liver damage, allergies, cervical.

If the patient has pain in the shoulder joints and redness of the skin is noticeable, then an inflammatory process may have begun in the shoulder. The following factors can provoke this action in the hand:

hemorrhage due to trauma or hemophilia;
poststreptococcal injury;
metabolic disorders;
autoimmune diseases.

Symptoms

Damage in the shoulder joint can form various causes, therefore, when diagnosing an ailment, doctors definitely need to identify the clinical picture. With a bruise, the patient develops an acute and small hematoma. For this reason, there may be a temporary restriction in the movement of the hand with severe pain.

Pain and crunch in the shoulder joint occurs when a dislocation or fracture occurs due to a fall on the arm or hard hit by her. Frequent increased pains limit any movement of the whole arm. When palpating the injured arm during dislocation, deformation of the joint zone is detected, and a crackling sound is heard during a fracture.

Minor fractures and dislocations can also occur in older patients from age-related bone loss and weakening of the ligaments.

Depending on the pathology, joint pain may manifest itself in different symptoms. Doctors have identified clinical manifestations for all sorts of reasons for an unpleasant symptom:

with tendonitis - sharp and nagging pain increasing character, progressing at night. Inflammatory process in the tendon occurs with excessive load on the shoulder and interferes with the free movement of the arm;
with bursitis - the symptom persists for several days, or even weeks. The damaged area constantly aches, swells, the shoulder joint hurts when raising the arm or moving the arm to the side;
with capsulitis - a aching pain is manifested, spreading to the arm and neck;
with arthritis - increased body temperature on the inflamed part of the joint, swelling is formed, it is painful and difficult for the patient to move his hand, the pain syndrome is periodic;
with arthrosis - there is a crunch and pain in the shoulder joint when moving. At the advanced stage of damage to the hand, the syndrome becomes a permanent manifestation. On palpation of the inflamed area, the pain radiates to the scapula and collarbone. The deformation of the joint begins;
at cervical osteochondrosis- the pain syndrome becomes more intense when moving the head or neck;
humeroscapular periarthritis - pain of a burning and pulling nature in the area of \u200b\u200bthe neck and arm when raising a hand or putting it behind the back, and the pain becomes more intense at night. Since this type of disease is a complication of cervical osteochondrosis, the limbs are affected. They can become numb and muscles atrophy;
when - the functionality of the shoulder joint is weakening, the arm is inactive and weak. Pain syndrome increases with physical activity;
with neuritis of the brachial nerve - pain in the right or left shoulder joint, and it manifests itself more intensely; discomfort appears.

For clinical picture it is also important to determine the localization of pain. The type of inflammation also depends on the location of the focus of inflammation. developing disease. In a patient, pain can be diagnosed in such places:

when raising the arm forward or moving it to the side;
when rotating the arm around the axis;
front of the hand;
when raising the arm vertically;
when lifting a heavy load;
with light movements - an attempt to comb, style hair, etc .;
when turning the head or moving the neck;
shoulder and neck pain at the same time;
pain attacks from the elbow to the shoulder;
the pain is localized in the shoulder and radiates to the back;
located in the shoulder and collarbone.

Diagnostics

During the detection of such a syndrome, in which the indicators become more intense, the patient must definitely seek the advice of a specialist. With such a problem, you can contact a traumatologist. When establishing a diagnosis, it is very important for the doctor to determine why the pain syndrome has developed. Depending on the localization and degree of manifestation of pain, the doctor can detect one or another pathology.

Pain in the shoulder joint of the left hand can occur not only with a stretch of the tendon, inflammation around joint bag or the deposition of salts, but also indicate serious illnesses, for which the patient needs urgent medical care to get rid of.

Pain in the shoulder joint right hand provoked by the same pathologies, as well as injuries, congenital anatomical anomalies, liver disease, radiculopathy, pneumonia,. Increasing pain in the joint of the right hand manifests itself from and. The following manifestations of pain and signs will indicate damage to the shoulder joint, and not muscle tissue:

pain is constant;
aggravated by movement and at rest;
diffuse syndrome;
movements are limited;
increase in joint size.

Depending on the clinical picture that the patient voiced, the doctor should refer the patient to more accurate diagnosis joint conditions. To establish accurate diagnosis, the patient should be examined narrow specialist. With pain in the shoulder joint, you can consult a neurologist, orthopedic traumatologist, cardiologist, rheumatologist, oncologist, allergist. After their examination, the patient needs to do the following examinations:

radiography;
arthroscopy;
tomography;
rheumatic tests;
biopsy - if oncological pathologies are suspected.

Treatment

In order for severe pain in the shoulder joint to subside, the patient needs to comprehensive examination. After diagnosing the inflamed area and establishing the exact disease, the patient is prescribed therapy. To eliminate all factors in the development of the disease, the patient is prescribed treatment from 4 components:

etiotropic - therapy for the cause of inflammation;
pathogenetic - to stop the development of the disease;
symptomatic - to reduce the manifestation of symptoms;
restorative for quick recovery joint performance and improvement of the general condition of the patient.

In the elimination of pain in the shoulder joints, the causes and treatment are interrelated. Therefore, to reduce the chances of developing complications and fast recovery the patient is assigned a full therapy of the four components listed above.

If the pain was provoked by a hand injury, then the patient needs to urgently apply cold compress to the inflamed area. Then the hemorrhage will stop a little and the swelling will decrease, and the discomfort will subside. Doctors eliminate pain in the joint of the right or left hand with traditional treatment:

applying a cold compress;
hand fixation;
elimination pain syndrome drugs;
external means - ointments.

If in the right or left shoulder joint it starts to hurt from overexertion, then the patient will have enough external influence by special means. Ointments and gels have analgesic and anti-inflammatory effects. Ointments consist of quickly absorbed ingredients that do not leave a greasy film, do not close pores and affect deep tissues.

Using means external action when a joint hurts, it is worth remembering that it is undesirable to apply them to damaged areas skin and mucous. Also, doctors do not recommend applying the cream under tight bandages or combining it with various warming items. If itching, burning or other allergic reaction the ointment must be washed off immediately.

To take drugs orally, doctors prescribe pills to patients. They need to be taken strict prescription. The doctor prescribes medicines to the patient, taking into account the state at the time of joint damage, the presence of other pathologies and possible allergies. The following drugs have an anti-inflammatory effect:

Diclofenac;
ibuprofen;
Indomethacin;
Meloxicam;
Xefocam;
Nimesulide.

With arthritis, arthrosis or bursitis, pain in the shoulder joint when you raise your arm can be eliminated with non-steroidal anti-inflammatory drugs and chondroprotectors. If the disease has developed to a complicated stage and the drugs used do not give the desired effect, then the doctor prescribes the patient the minimum use of hormones and drugs with narcotic analgesics. These drugs are taken to reduce the risk of developing cancer.

If the shoulder joint begins to deform, then traditional treatment will be ineffective. In this case, physicians resort to radical methods therapy - operational assistance. The patient is undergoing joint arthroplasty.

When periarthritis is detected, the patient is prescribed analgesics and anti-inflammatory drugs that eliminate pain in the left shoulder joint. In case the disease proceeds with a strong inflammatory character, the patient needs to apply glucocorticosteroid ointments and injections.

Shoulder-shoulder periarthritis- inflammation of the tendons of the shoulder. Other names for this disease are capsulitis, "frozen shoulder".
One of the methods of treatment is special therapeutic exercises.
This video shows a set of exercises for the treatment of shoulder pain.

The exercises in this video are helpful:

for the treatment of humeroscapular periarthritis and capsulitis;
for the treatment of arthrosis of the shoulder joint;
to improve shoulder mobility after chronic hand injuries;
with limited mobility in the arm after breast surgery;
with pain in the shoulders caused by impaired blood circulation in the shoulder joint.

****

Often, doctors, with any complaints of a patient about pain in the shoulders, immediately diagnose "arthrosis of the shoulder joints."

But in fact, osteoarthritis of the shoulder joints is quite rare. If you make a certain rating for the causes of pain in the shoulder joints, then arthrosis would take only 3rd or even 4th place in this rating - arthrosis accounts for only 5-7% of total number all cases of pain in the shoulder joints.

The first two places in this ranking would be firmly occupied by humeroscapular periarthritis and injuries cervicothoracic spine with radicular symptoms.
These two diseases account for up to 80% of all cases of shoulder pain.

Another 5-7% is accounted for by arthritis. And a few more percent of people suffer from shoulder pain for other reasons: vascular disorders, stiffness of the neck muscles, diseases of the liver, heart, etc.

Shoulder-shoulder periarthritis is an inflammation of the tendons of the shoulder and the capsule of the shoulder joint.. But deep internal structures joint, the joint itself and the cartilage of the joint are not damaged. This is the difference between humeroscapular periarthritis and arthrosis of the shoulder joint or arthritis.

Causes of humeroscapular periarthritis

Shoulder-shoulder periarthritis is very common. Sooner or later, up to a quarter of the entire population of the globe faces this disease. And everyone gets sick - both women and men.

The disease usually develops after some injury, a blow to the shoulder, a fall on the shoulder or an outstretched arm. Or starts after excessive physical activity.

For example, one patient fell ill after walking her dog - for two hours she threw a stick, which the dog gladly brought back. The second got inflammation of the shoulder tendons after ten hours of continuous and unaccustomed painting work.
And the homegrown "sportsman" had an inflamed shoulder after an impromptu arm wrestling - he "under vodka" measured his strength with his friends.

That is, in all these cases, the cause of humeroscapular periarthritis was unusual activity and overload for a long time not trained shoulder joints. This is a typical scenario for the development of the disease, although many patients find it difficult to remember their "exercises" that led to malaise - after all, with periarthritis there is always some delay. For example, overload or injury occurs today - inflammation and pain occur after 3-7 days.

Surprisingly, the development of periarthritis can also contribute to some diseases of the internal organs. For example, left-sided humeroscapular periarthritis sometimes occurs as consequence of myocardial infarction. With a heart attack, a spasm or death of the group occurs blood vessels, which often leads to a deterioration in blood circulation in the left shoulder area. Without proper blood supply, the tendon fibers become brittle, spasm, tear, swell and become inflamed.

Liver disease, in turn, can provoke the development of periarthritis in the right shoulder.

More periarthritis often occurs in women who have undergone surgery to remove the breast. Sometimes this is due to the fact that such an operation changes the blood flow in areas adjacent to the chest, and sometimes due to the fact that important nerves or vessels are affected during the operation.

And, of course, the development of humeroscapular periarthritis is promoted diseases of the cervical spine. Displacement of the intervertebral joints in the neck or chronic spasm of the cervical muscles lead to the fact that the nerves of the cervical-brachial plexus are infringed. Infringement of the nerves causes a response reflex spasm of the vessels going to the arm.

As a result, the blood circulation of the arm (and shoulder) is disturbed, Shoulder tendons swell and become inflamed. Due to the fact that the shoulder joint is very complex, inflammation of the tendons around it is sometimes extremely difficult - after all, in the shoulder area it is intertwined a large number of tendons, ligaments, small muscles, vessels and nerve trunks. And all this complex structure very quickly “responds” with inflammation to any damaging effect, whether it is overload, tear or inflammation of individual ligaments and tendons.

Symptoms of humeroscapular periarthritis

The disease can occur in several variants and take different forms.

For example, there is mild form this disease - simple humeroscapular periarthritis. With simple humeroscapular periarthritis, pain in the shoulder is very weak and occurs only with certain hand movements.

The mobility of the arm is not strong, but it decreases: there is a restriction of movement in the shoulder - it is impossible to stretch the arm up or bring it far behind the back, touch the spine with the knuckles.

Pain also occurs when the patient tries to make hand movements when the doctor fixes it. Indeed, at this moment, the affected tendon is tensed. Particularly painful in this situation are the patient's attempts to raise his hand up, overcoming resistance doctor. Or attempts, overcoming resistance, to rotate the arm straightened at the elbow around its axis - clockwise or counterclockwise.

Surprisingly, the same movements, performed without resistance, bring absolutely no discomfort.

This form of the disease is easily treatable, and sometimes discomfort disappears by itself in 3-4 weeks. However, without treatment, simple humeroscapular periarthritis can easily transform into spicy humeroscapular periarthritis. This transformation occurs in about 60% of cases and is usually preceded by additional trauma or overuse of the affected shoulder.

Although sometimes acute humeroscapular periarthritis occurs on its own, as an independent primary disease- on the background severe damage hands and a sharp response of the body to this damage. This response of the body results in sudden increasing pain in the shoulder that radiates to the neck and arm.
The pain gets worse at night. Hand movements through the side up, as well as rotation of the hand around its axis, are difficult and cause sharp pain, while moving the arm forward is more free and almost painless.

characteristic appearance the patient - he tries to keep his arm bent at the elbow and pressed to his chest. When examining the patient, a slight swelling may be noted on the anterior surface of the shoulder.
General state patients are often worsened by severe pain and the resulting insomnia. Maybe even slight temperature(within 37.2-37.5ºСº).

An acute attack lasts for several weeks, then the intensity pain decreases slightly, movement in the shoulder is partially restored.

Alas, but in about half of the cases, the disease passes into next stage — chronic humeroscapular periarthritis. Chronic humeroscapular periarthritis is manifested by moderate pain in the shoulder, with which many patients could well come to terms. But periodically, with unsuccessful movements or rotation of the arm, the sore shoulder shoots acute pain. In addition, in some patients, sleep is disturbed due to a feeling of ache in the shoulder, which most often manifests itself especially strongly in the second half of the night, in the morning.

In this form, chronic humeroscapular periarthritis can exist for a long time, from several months to several years, after which the disease in some cases "resolves by itself" - sometimes even without any medical intervention.

However, in a third of patients, chronic humeroscapular periarthritis transforms into ankylosing periarthritis (capsulitis, "frozen shoulder"). This form of the disease is the most unfavorable, and it can develop not only as a continuation of other forms of humeroscapular periarthritis, but also independently.
In this form of periarthritis, the pain in the affected shoulder is dull at first, but is accompanied by a severe deterioration in the mobility of the shoulder. The shoulder becomes very tight to the touch and indeed looks frozen.

Most of the hand movements that involve the shoulder result in sharp pain. Some patients say that, compared to frozen shoulder pain, toothache- "flowers". Although there are also forms of "frozen shoulder" in which there is practically no pain, but the shoulder is blocked and immobilized.

In any case, whether there is pain or not, with a frozen shoulder, a sick person always loses the opportunity to normally raise his arm up - a straightened arm forward does not rise above shoulder level; and through the side it rises even worse - it happens that it is impossible to raise the arm from the hip to the side by more than 40-50 centimeters. In addition, the hand practically ceases to rotate around its axis, and it is impossible to bring it behind the back.

Another form of humeroscapular periarthritis, inflammation of the long bicep heads, occurs mainly in men due to microtrauma that occurs after a sharp movement of the hand, or after a blow to the front surface of the shoulder. Pain with inflammation of the long head of the biceps shoots into the front surface of the shoulder. It is rarely permanent; most often the pain occurs unexpectedly, with some movements.
Usually painful lifting of weights from the floor, as well as flexion and extension of the arm bent at the elbow, especially carried out with resistance - that is, when someone interferes with these movements.

Test

Normally, you should be able to move your shoulder in all directions without causing pain or tension. To test the mobility of your shoulder, do the following exercises:

Raise both straight arms up;
Raise your hands straight in front of you;
Spread your arms on both sides of the body;
Put your hand behind your back (imagine you are trying to correct back dress or take your wallet out of the back pocket of your trousers).

Treatment of humeroscapular periarthritis is desirable to start as early as possible, until the disease is started. Shoulder-shoulder periarthritis is treated with painkillers from the group of non-steroidal anti-inflammatory drugs diclofenac, piroxicam, ketoprofen, indomethacin, butadione, meloxicam, celebrex, nimulide and their derivatives), physiotherapy, massage, acupuncture.
Along with therapeutic methods prescribed by the doctor, therapeutic exercises with special exercises aimed at improving the mobility of the joint capsule.

Contraindications to therapeutic exercises

For all their usefulness, these exercises cannot be performed:

with fresh shoulder injuries, dislocations of the shoulder joint and sprains of the shoulder ligaments;
with chronic and habitual shoulder dislocations;
at elevated temperature body (above 37.5 ºС);
with influenza, SARS and tonsillitis - you have to wait for recovery and wait another 3-4 days;
in the first 2-3 months after breast surgery;
at least 3 months after neck surgery;
at least 3 months after shoulder surgery; in the future - only in agreement with the operating surgeon.

Attention! If a particular exercise causes sharp pain, then it is contraindicated for you or you are doing it incorrectly. In this case, it is better not to do it, or at least postpone it until a consultation with your doctor.

A set of exercises for shoulder pain

Extended, slightly more extensive than in the video, a set of exercises for the treatment of shoulder joints

❧ Control one. slowly and smoothly make circular movements with your shoulders: for about one minute in a circle forward and then one minute in a circle back.

❧ Control 2. Sitting on a chair. Place your palms on your waist. Spread your elbows out to the sides. Maintaining the starting position slowly and smoothly move your shoulders to the limit forward. Then - all the way back. Repeat shoulder movements forward and backward 5-6 times.

❧ Control 3. Performed sitting. Place your affected arm behind your back as far as possible. Grab your sore hand behind your back good hand by the wrist and pull the sore hand to the opposite buttock, as far as possible without pain - only until you feel muscle tension. In the extreme position, hold your hands for 7-10 seconds, then, while inhaling, strain the sore arm as much as possible and hold this tension for 10-12 seconds.

Then exhale, and as you exhale, relax the affected arm. As long as the injured hand is relaxed, soft pull it with your healthy hand a few centimeters further (toward the buttocks from the healthy side) - again until you feel a slightly painful muscle tension. Re-fix the achieved position for 7-10 seconds. Then again perform the stage of tension of the sore arm and its subsequent relaxation. In just one approach, 4-5 cycles of tension-relaxation of the sore arm are performed.

❧ Control four. Performed sitting. Place the hand of the affected arm on the opposite shoulder, press the elbow of the affected arm against the body. Grasp the elbow of the affected arm with your good hand. Now smoothly and gently pull the elbow of the sore arm up. In this case, the elbow of the sore arm should not come off the body, it seems to slide along the chest. And the palm of the diseased hand slides along the healthy shoulder, as if bending around it.

Pulling the elbow of the sore arm as high as possible without pain, but until you feel muscle tension, hold the achieved position for 10-15 seconds. Then, while inhaling, strain the sore arm as much as possible, as if resisting movement with the sore hand. The tension lasts 7-10 seconds, after which the sore hand must be relaxed, and with a healthy hand it is necessary to lead the elbow of the sore hand a little more up to feeling light soreness and muscle tension.

Re-fix the position for 10-15 seconds, then repeat the stage of tension of the sore arm and its subsequent relaxation. Each time, move the elbow of the affected arm at least 1- further up. Repeat the whole reception 5-6 times.

❧ Control 5. This exercise should be done for those patients who have a severe limitation of the mobility of the shoulder joint and the arm is poorly retracted to the side. The exercise is performed in two versions: simplified and standard. The first days you need to do a simplified version, and only then, if the simplified version is given to you without any problems, you need to move on to the standard exercise.

Simplified version performed on the floor, lying on your back. The patient's arm is straightened at the elbow, laid aside and lies on the floor with the palm up. Without changing general position hands, lift it off the floor by 2-, and strongly strain the whole arm. Make sure that the arm remains straight at the elbow, and the palm looks straight up. Hold the tension for 7-10 seconds, then lower your hand and completely relax it for 10-15 seconds.

Then inhale, while inhaling, again slightly raise your arm 2-3 cm from the floor, and strain it strongly. Hold the tension for 7-10 seconds. As you exhale, lower your hand again and completely relax it for 10-15 seconds. Perform 4-5 cycles of tension-relaxation of the sore arm. The alternation of tension-relaxation will allow the tendons of the sore shoulder to gradually stretch.

It is performed in much the same way as the simplified one, but lying on the couch (or on the bed). The shoulder of the sore arm should be located on the very edge of the sofa (or bed), the sore arm straightened at the elbow is laid aside and hangs slightly down. The palm is still looking up.

Without changing the position of the hand, tighten the hand strongly. Hold the tension in your hand for 7-10 seconds, then relax your hand and let it freely, under the influence of gravity, fall down until you feel tension (but not pain). Make sure that the arm remains straight at the elbow, and the palm is looking up. Let the relaxed arm hang freely for 10-15 seconds, then inhale, slightly raise the arm (2-3 cm from the previously reached position) and strain it again. Hold the tension for 7-10 seconds.

Then, as you exhale, relax your arm again and let it drop down freely under the influence of gravity a few more centimeters down. Perform 4-5 such cycles of tension-relaxation of the sore arm.

❧ Control 6. This exercise should be done for those patients who have a strong rotational limitation of the mobility of the shoulder joint, that is, the arm does not rotate well in the shoulder joint. Like the previous exercise, it is performed in two versions: simplified and standard. The first days you need to do a simplified version, and only then, if the simplified version is given to you without problems, you need to move on to the standard exercise.

Simplified version performed on the floor, lying on your back. The patient's arm is bent both at the shoulder and at the elbow approximately at an angle of 90°, turned palm up. Part of the arm from the elbow to the palm is relaxed and, if possible, lies freely on the floor. Without changing the position of the hand, strain the sore arm strongly, raising the palm 1-2 cm from the floor, and hold the tension for 10-15 seconds. After 10-15 seconds, completely relax your arm and let it lie back down on the floor.

Relaxation lasts about 10 seconds, then strain your arm again and hold the tension for 10-15 seconds, again raising your palm by 1-2 cm. Then repeat the relaxation of the arm again. Perform 4-5 cycles of tension-relaxation of the sore arm. The alternation of tension-relaxation will allow the tendons of the "rotator cuff" of the sore shoulder to gradually stretch.

Standard exercise: It is performed in much the same way as the simplified one, but lying on the couch (or on the bed). The shoulder of the sore arm should be located closer to the edge of the sofa (or bed). The patient's arm is bent both at the shoulder and at the elbow approximately at an angle of 90°, turned palm up. Part of the arm from the elbow to the palm is relaxed and hangs freely. Without changing the position of the hand, strongly strain the sore arm and hold the tension for 10-15 seconds. After 10-15 seconds, relax your arm and let your arm from the elbow to the palm freely, under the influence of gravity, fall down.

Relaxation lasts about 15 seconds, then strain your arm again and hold the tension for 10-15 seconds. Then repeat the relaxation of the hand again (again for 10-15 seconds). Perform the reception 3-4 times, allowing the hand to fall lower and lower each time, turning around its axis.

❧ Control 7. This exercise should also be done for those patients who have a strong rotational limitation of the mobility of the shoulder joint, that is, the arm does not rotate well in the shoulder joint. Like the two previous exercises, it is performed in a simplified and standard options. The first days you need to do a simplified version, and only then, if the simplified version is given to you without problems, you need to move on to the standard exercise.

Simplified version performed on the floor, lying on your back. The affected arm is bent at both the shoulder and the elbow at an angle of approximately 90°, but is now turned palm down.

Without changing the position of the hand, strain the arm strongly, lifting the hand 1-2 cm from the floor, and hold the tension for 10-15 seconds. Relax your arm completely after 10-15 seconds. Relaxation lasts about 10 seconds, after which again strain your arm and hold the tension for 10-15 seconds, again raising the brush by 1-2 cm. Then repeat the relaxation of the arm again.

Perform 4-5 cycles of tension-relaxation of the sore arm. The alternation of tension-relaxation will allow the tendons of the "rotator cuff" of the sore shoulder to gradually stretch.

Standard exercise: It is performed in much the same way as the simplified one, but lying on the couch (or on the bed). As in exercise number 6, the shoulder of the sore arm is located closer to the edge of the sofa; the affected arm is bent at both the shoulder and the elbow at an angle of approximately 90°, but is now turned palm down. Part of the arm from the elbow to the palm is relaxed and hangs freely.

Without changing the position of the hand, strongly strain the hand, and hold the tension for 10-15 seconds. Then completely relax the arm, allowing the arm from the elbow to the palm to freely, under the influence of gravity, fall down. Relaxation lasts about 10 seconds, then again strain your arm for 10-15 seconds. Then repeat the relaxation of the arm again (10-15 seconds). Perform the reception 3-4 times, allowing the hand to fall lower and lower each time, turning around its axis.

❧ Control eight. Standing near the chair, lean forward, lean on the chair with your healthy hand. Lower the affected arm and let it hang freely for 10-20 seconds. Then begin light pendulum-like "swaying" movements with a relaxed sore arm in different directions: back and forth, then in a circle - clockwise and counterclockwise. Gradually increase the range of motion, but do it without overt pain. Perform these movements for 3-5 minutes.

❧ Control 9. Stand facing the wall. Raise your affected arm as far as you can without pain. Choose a point on the top of the wall that is still difficult for you to reach with your sore hand - about 10- higher than the place that you reach with your fingers now.

Now, moving your fingers along the wall, start slowly moving towards the cherished point. Naturally, you need to stretch with your hand, and not by lifting on your toes. And, as always, the main rule is to avoid pain during the exercise. Stretch your hand up slowly, gradually. And follow the rule of alternating tension with relaxation: for about 20 seconds we actively stretch, then for 10 seconds we slightly relax the arm (but without lowering it much down). We stretch again, then slightly relax the hand again. And so several times.

Performing the exercise daily, for 2-3 minutes a day, you will gradually significantly expand the range of motion in the sore arm.

Exercise rules

You need to do exercises daily, 1-2 times a day, for at least 3-4 weeks.
When exercising, be careful and avoid sharp pain. Although moderate, tolerable pain caused by tendon traction is almost inevitable when performing these exercises. The main thing here is not to "overdo it."
You need to gradually increase the load and increase the mobility of the hands.

Attention! When performing the exercise, you do not need to follow your hand with your eyes, throwing your head back too actively.
In people with "unstable" cervical region tilting the head back can lead to dizziness and even loss of consciousness - due to impaired blood flow in the basilar artery!

And remember that even with the right gymnastics, improvement does not come immediately. In the first 2 weeks of training, joint pain may even increase a little, but after 3-4 weeks you will feel a clear improvement in well-being.
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I wish you the will and perseverance necessary to return the former ease of movement!

Pain and inflammation in the shoulder joint.

The main causes of pain in the shoulder joints

Undoubtedly, humeroscapular periarthritis and injuries of the cervicothoracic spine with radicular symptoms occupy the first place among the causes of pain in the shoulder area. They account for about 80 percent of such cases. The remaining 20% share arthrosis and arthritis of the shoulder joint as the cause, causing appearance pain sensations. A few percent of people suffer from shoulder pain for other reasons: due to vascular disorders, stiffness of the neck muscles, diseases of the liver, pancreatic heart. Doctors say the pain radiates to the shoulder joint.

Shoulder-shoulder periarthritis is an inflammation of the tendons of the shoulder and the capsule of the shoulder joint. But the deep internal structures of the joint and the cartilage of the joint are not damaged - this is the difference between humeroscapular periarthritis and arthrosis of the shoulder.

Causes of humeroscapular periarthritis

Shoulder-shoulder periarthritis is very common. Sooner or later, up to a quarter of the entire population of the globe faces this disease. And everyone gets sick - both women and men.

The disease usually develops after some injury, a blow to the shoulder, a fall on the shoulder or an outstretched arm, a sharp throw of an object with a hand. Or starts after an unexpected excessive physical activity.

Such a load can be any unusual in Everyday life traffic. For example, during the repair of an apartment, intensive work in the country, active games in badminton in the summer and other sharp or monotonously repeated unusual movements.

That is, in all these cases, the cause of humeroscapular periarthritis was unusual activity and overload for a long time not trained shoulder joints. This is a typical scenario for the development of the disease, although many patients find it difficult to remember their moments of overload, which later led to pain in the joint - after all, with periarthritis there is always some delay. If the injury occurs today, inflammation and pain will not occur until a few days or a week later.

Other causes of humeroscapular periarthritis

The development of periarthritis can lead to diseases of the chest and abdominal cavity, such as:

Postponed myocardial infarction. Many people know that heart problems - angina pectoris can radiate (give away) to left hand. This occurs due to a reflex vasospasm in the arm area, which leads to a deterioration in blood circulation in the left shoulder area. Without proper blood supply, the tendon fibers of the joint become brittle, hard, and tear, and then swell and become inflamed. There is periarthritis. (“peri” is near, and “arthritis” is inflammation).

Liver disease can provoke the development of periarthritis in the right shoulder.

Periarthritis can occur in women who have had surgery to remove the breast. This is due to the fact that after the operation, the blood flow in the areas adjacent to the chest, namely in the shoulder area, may change.

And probably the most main reason development of humeroscapular periarthritis diseases of the cervical spine. Displacement of the intervertebral joints about the region of the cervical region or chronic spasm of the cervical muscles lead to the fact that they are infringed nerve roots that innervates the brachial plexus. Infringement of the nerves causes a response reflex spasm of the vessels that feed the tissues of the hand. As a result, the blood circulation of the arm (and shoulder) is disturbed, the tendons of the shoulder swell and become inflamed.

Due to the complex structure of the shoulder joint, inflammation of the tendons, ligaments and articular bag of the joint is extremely difficult - after all, in the shoulder area there are a large number of tendons, ligaments, small muscles, blood vessels and nerve trunks. And all this complex structure very quickly reacts with inflammation to any damaging factor.

Symptoms of humeroscapular periarthritis

The disease can occur in several variants and take different forms.

Simple humeroscapular periarthritis - mild form of this disease.

With simple humeroscapular periarthritis shoulder pain very weak and occur only with certain movements of the hand or in the load. Feels some restriction of movement in the shoulder- it is impossible to stretch your hand up or bring it far behind your back, touch your fingers to the spine. Pain also occurs when trying to make hand movements, when the doctor prevents this by holding the hand. At this point, there is tension in the affected tendon.

Particularly unpleasant and painful are the patient's attempts to raise his arm up, or attempts to rotate the arm straightened at the elbow around its axis - clockwise or counterclockwise, overcoming the resistance doctor.

At mild form suffering, the same movements performed without resistance, do not bring absolutely no discomfort.

This form of the disease is easily treatable, and sometimes discomfort disappears by itself in 3-4 weeks.

However, without treatment, simple humeroscapular periarthritis, in about 60% of cases, can easily go into the following phase: .

This is usually preceded by an additional injury or overload of an already sore shoulder.

But acute humeroscapular periarthritis may occur in the background full health on my own, like independent disease- against the background of a severe injury to the hand and a pronounced response of the body to this injury.

This response of the body results in sudden increasing pain in the shoulder that radiates to the neck and arm. The pain often gets worse at night.

Hand movements through the side up, as well as rotation of the hand around its axis, are difficult and cause sharp pain, while moving the hand forward is more free and almost painless.

The appearance of the patient is characteristic - he tries to keep his arm bent at the elbow and pressed to his chest. When examining a patient on the anterior surface of the shoulder, there may be a slight swelling in the area of the affected ligament and joint capsule. The temperature may rise (37.2-37.5ºСº). This is caused by progressive reactive inflammation of the joint, which is no longer able to go away on its own.

The acute period lasts for several weeks, then the intensity of the pain decreases slightly, the movement in the shoulder is partially restored.

Alas, but in half the cases, in the absence of adequate medical assistance, the disease passes into the next phase - chronic humeroscapular periarthritis .

Chronic humeroscapular periarthritis is characterized by moderate pain in the shoulder joint, which many patients are ready to put up with, just to avoid going to the doctors. This is the wrong decision. Precious time will be lost. And the process of destruction cartilage tissue continues in the joint. Periodically, with unsuccessful movements or rotation of the arm, the sore shoulder shoots with acute pain.

In many patients, sleep is disturbed due to a feeling of ache in the shoulder, which is especially pronounced at night and especially in the morning.

Chronic humeroscapular periarthritis can exist in this form for a long time, from several months to several years. Cases of self-healing are known, but in about a third of patients, chronic humeroscapular periarthritis is transformed into ankylosing periarthritis - "frozen shoulder".

This form of the disease is the most unfavorable. It can be said that this is its final stage. This is the point, after which it is no longer possible to return everything back ... as it was. In some large ones, this form of the disease can develop on its own after a severe injury, bypassing the previous stages of the process.

With this form of periarthritis, pain in the affected shoulder is not sharp at first, but dull, but at the same time, they are accompanied by a strong limitation of shoulder mobility.

Shoulder becomes very tight and hard to the touch and indeed looks like frozen.

Hand movements lead to sharp pain. Some patients say that this is the worst pain they have ever experienced.

There are such forms ankylosing periarthritis , in which there is practically no pain, but the shoulder is completely blocked and there is no movement in it. The bones that take part in the formation of the joint are completely fused. This process is called ankylosis.

In any case, whether the patient is in pain or not, with a frozen shoulder, it is not possible to normally raise the arm up and forward. A straightened arm does not rise above shoulder level, and through the side it rises even worse. Most often, it is impossible to raise the arm from the hip to the side by more than 30-40 centimeters. In addition, the hand practically ceases to rotate around its axis, it is impossible to bring it behind the back.

Diagnosis of humeroscapular periarthritis

Diagnosis of humeroscapular periarthritis is based on characteristic symptoms diseases detected during examination of the patient, identification pain points in the places of attachment of the tendons and the definition of typical painful movements of the hand.

Sometimes an x-ray of the shoulder joint is needed to clarify the diagnosis. Although characteristic changes in the picture, the doctor can only see when he has already gone far, chronic process. On the pictures, you can find deposits of calcium microcrystals in the places of attachment of the affected tendons to the bones, sharpening and calcification of the places of attachment ligamentous apparatus joint. Accumulations of microcrystals that cause calcification of the ligaments are also found above the shoulder joint, in the subdeltoid synovial bag.

Rarely, in severe ankylosing periarthritis, x-ray shows loss of head density humerus as manifestations of osteoporotic changes.

Indicators clinical analysis blood remains normal in all types of humeroscapular periarthritis, except for its acute form. In acute humeroscapular periarthritis, the ESR and the amount of C-reactive protein increase in the blood test.

Treatment of humeroscapular periarthritis

The disease, as a rule, responds well to therapy if it is started on time, given the phase and severity of the process. Treatment of humeroscapular periarthritis is desirable to start as early as possible, until the disease is started. And first you need to try to eliminate the cause of the disease, if possible.

The current treatment methods allow you to quickly stop pain and subsequently completely cure humeroscapular periarthritis, if it has not yet reached the point of complete ankylosing (fusion) of the bones involved in the formation of the “frozen shoulder” joint.

If the development of periarthritis has led to the displacement of the intervertebral joints and their blocking in case of severe osteochondrosis or instability of the cervical spine, it is necessary to carry out manual therapy to restore normal joint relations. Subsequently, anti-arthrotic, anti-inflammatory, chondroprotective and angioprotective therapy is prescribed. June.

You can speed up the healing process if you combine different methods treatment: the introduction of anti-inflammatory and anti-arthritis drugs, the use of post-isometric relaxation and massotherapy, soft manual therapy. But you need to start a course of post-isometric relaxation and massage 2-3 days after periarticular injections of corticosteroid drugs.

Give a good effect compresses with dimexide or bischofite(however in acute stage bischofite disease cannot be used).

In some cases, daily intensive magnetic therapy helps, laser therapy,as physiotherapy treatments.

Hirudotherapy (leeches) in patients with humeroscapular periarthritis often cause allergies.

When writing the essay, materials from the site of Dr. Evdokimenko were used www.evdokimenko.ru

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Center for Vertebrology Dr. Vladimirov

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Shoulder-shoulder periarthritis - inflammation of the tendons of the shoulder. Other names for this disease are capsulitis, "frozen shoulder".
One of the methods of treatment is special therapeutic exercises.
This video shows a set of exercises for the treatment of shoulder pain.

The exercises in this video are helpful:

for the treatment of humeroscapular periarthritis and capsulitis;
for the treatment of arthrosis of the shoulder joint;
to improve shoulder mobility after chronic hand injuries;
with limited mobility in the arm after breast surgery;
with pain in the shoulders caused by impaired blood circulation in the shoulder joint.

****

Often, doctors, with any complaints of a patient about pain in the shoulders, immediately diagnose "arthrosis of the shoulder joints."

But in fact, osteoarthritis of the shoulder joints is quite rare. If you make a certain rating for the causes of pain in the area of the shoulder joints, then arthrosis would take only 3rd or even 4th place in this rating - only 5-7% of the total number of all cases of pain in the area of the shoulder joints fall on the share of arthrosis.

The first two places in this rating would be firmly occupied by humeroscapular periarthritis and injuries of the cervicothoracic spine with radicular symptoms.
These two diseases account for up to 80% of all cases of shoulder pain.

Another 5-7% is accounted for by arthritis. And a few more percent of people suffer from shoulder pain for other reasons: due to vascular disorders, stiffness of the neck muscles, diseases of the liver, heart, etc.

Shoulder-shoulder periarthritis is an inflammation of the tendons of the shoulder and the capsule of the shoulder joint.. But the deep internal structures of the joint, the joint itself and the cartilage of the joint are not damaged. This is the difference between humeroscapular periarthritis and arthrosis of the shoulder joint or arthritis.

Causes of humeroscapular periarthritis

Shoulder-shoulder periarthritis is very common. Sooner or later, up to a quarter of the entire population of the globe faces this disease. And everyone gets sick - both women and men.

The disease usually develops after some injury, a blow to the shoulder, a fall on the shoulder or an outstretched arm. Or starts after excessive physical activity.

Surprisingly, the development of periarthritis can also contribute to some diseases of the internal organs. For example, left-sided humeroscapular periarthritis sometimes occurs as consequence of myocardial infarction. With a heart attack, a spasm or death of a group of blood vessels occurs, which often leads to a deterioration in blood circulation in the left shoulder area. Without proper blood supply, the tendon fibers become brittle, spasm, tear, swell and become inflamed.

Liver disease, in turn, can provoke the development of periarthritis in the right shoulder.

As a result, the blood circulation of the arm (and shoulder) is disturbed, Shoulder tendons swell and become inflamed. Due to the fact that the shoulder joint is very complex, inflammation of the tendons around it is sometimes extremely difficult - after all, a large number of tendons, ligaments, small muscles, blood vessels and nerve trunks are intertwined in the shoulder area. And all this complex structure very quickly “responds” with inflammation to any damaging effect, whether it is overload, tear or inflammation of individual ligaments and tendons.

Symptoms of humeroscapular periarthritis

The disease can occur in several variants and take different forms.

For example, there is a mild form of this disease - simple humeroscapular periarthritis. With simple humeroscapular periarthritis, pain in the shoulder is very weak and occurs only with certain hand movements.

Surprisingly, the same movements, performed without resistance, bring absolutely no discomfort.

Although sometimes acute humeroscapular periarthritis occurs on its own, as an independent primary disease, against the background of severe damage to the hand and a sharp response of the body to this damage. This response of the body results in sudden increasing pain in the shoulder that radiates to the neck and arm.
The pain gets worse at night. Hand movements through the side up, as well as rotation of the hand around its axis, are difficult and cause sharp pain, while moving the hand forward is more free and almost painless.

The appearance of the patient is characteristic - he tries to keep his arm bent at the elbow and pressed to his chest. When examining the patient, a slight swelling may be noted on the anterior surface of the shoulder.
The general condition of patients often worsens due to severe pain and insomnia caused by them. There may even be a slight temperature (within 37.2-37.5ºСº).

An acute attack lasts for several weeks, then the intensity of pain decreases slightly, movement in the shoulder is partially restored.

Alas, in about half of the cases, the disease passes into the next stage - chronic humeroscapular periarthritis. Chronic humeroscapular periarthritis is manifested by moderate pain in the shoulder, with which many patients could well come to terms. But periodically, with unsuccessful movements or rotation of the arm, the sore shoulder shoots with acute pain. In addition, in some patients, sleep is disturbed due to a feeling of ache in the shoulder, which most often manifests itself especially strongly in the second half of the night, in the morning.

Most of the hand movements that involve the shoulder result in sharp pain. Some patients say that compared to the pain in the “frozen shoulder”, toothache is “flowers”. Although there are also forms of "frozen shoulder" in which there is practically no pain, but the shoulder is blocked and immobilized.

Another form of humeroscapular periarthritis, inflammation of the long head of the biceps, occurs mainly in men due to microtrauma that occurs after a sharp movement of the hand, or after a blow to the front surface of the shoulder. Pain with inflammation of the long head of the biceps shoots into the front surface of the shoulder. It is rarely permanent; most often the pain occurs unexpectedly, with some movements.
Usually painful lifting of weights from the floor, as well as flexion and extension of the arm bent at the elbow, especially carried out with resistance - that is, when someone interferes with these movements.

Test

Normally, you should be able to move your shoulder in all directions without causing pain or tension. To test the mobility of your shoulder, do the following exercises:

Raise both straight arms up;
Raise your hands straight in front of you;
Spread your arms on both sides of the body;
Place your hand behind your back (imagine trying to straighten the back of your dress or pull your wallet out of your back pocket).

Treatment of humeroscapular periarthritis is desirable to start as early as possible, until the disease is started. Shoulder-shoulder periarthritis is treated with painkillers from the group of non-steroidal anti-inflammatory drugs diclofenac, piroxicam, ketoprofen, indomethacin, butadione, meloxicam, celebrex, nimulide and their derivatives), physiotherapy, massage, acupuncture.
Along with the therapeutic methods prescribed by the doctor, therapeutic exercises with special exercises are needed to improve the mobility of the joint capsule.

Contraindications to therapeutic exercises

For all their usefulness, these exercises cannot be performed:

with fresh shoulder injuries, dislocations of the shoulder joint and sprains of the shoulder ligaments;
with chronic and habitual shoulder dislocations;
at elevated body temperature (above 37.5 ºС);
with influenza, SARS and tonsillitis - you have to wait for recovery and wait another 3-4 days;
in the first 2-3 months after breast surgery;
at least 3 months after neck surgery;
at least 3 months after shoulder surgery; in the future - only in agreement with the operating surgeon.

A set of exercises for shoulder pain

Extended, slightly more extensive than in the video, a set of exercises for the treatment of shoulder joints

❧ Control one. slowly and smoothly make circular movements with your shoulders: for about one minute in a circle forward and then one minute in a circle back.

❧ Control 3. Performed sitting. Place your affected arm behind your back as far as possible. Behind your back, grab the affected hand with your healthy hand at the wrist and pull the affected hand to the opposite buttock, as far as possible without pain - just until you feel muscle tension. In the extreme position, hold your hands for 7-10 seconds, then, while inhaling, strain the sore arm as much as possible and hold this tension for 10-12 seconds.

Simplified version performed on the floor, lying on your back. The patient's arm is straightened at the elbow, laid aside and lies on the floor with the palm up. Without changing the general position of the arm, raise it above the floor by 2-, and strongly strain the entire arm. Make sure that the arm remains straight at the elbow, and the palm looks straight up. Hold the tension for 7-10 seconds, then lower your hand and completely relax it for 10-15 seconds.

Then, as you exhale, relax your arm again and let it drop down freely under the influence of gravity a few more centimeters down. Perform 4-5 such cycles of tension-relaxation of the sore arm.

❧ Control 7. This exercise should also be done for those patients who have a strong rotational limitation of the mobility of the shoulder joint, that is, the arm does not rotate well in the shoulder joint. Like the two previous exercises, it is performed in a simplified and standard version. The first days you need to do a simplified version, and only then, if the simplified version is given to you without problems, you need to move on to the standard exercise.

Simplified version performed on the floor, lying on your back. The affected arm is bent at both the shoulder and the elbow at an angle of approximately 90°, but is now turned palm down.

Perform 4-5 cycles of tension-relaxation of the sore arm. The alternation of tension-relaxation will allow the tendons of the "rotator cuff" of the sore shoulder to gradually stretch.

❧ Control eight. Standing near the chair, lean forward, lean on the chair with your healthy hand. Lower the affected arm and let it hang freely for 10-20 seconds. Then begin light pendulum-like "swaying" movements with a relaxed sore arm in different directions: forward and backward, then in a circle - clockwise and counterclockwise. Gradually increase the range of motion, but do it without overt pain. Perform these movements for 3-5 minutes.

Performing the exercise daily, for 2-3 minutes a day, you will gradually significantly expand the range of motion in the sore arm.

Exercise rules

Attention! When performing the exercise, you do not need to follow your hand with your eyes, throwing your head back too actively.
In people with an "unstable" cervical spine, tilting the head can lead to dizziness and even loss of consciousness - due to impaired blood flow in the basilar artery!

I wish you the will and perseverance necessary to return the former ease of movement!

This simple exercise, available to perform at any age and with any body type, will develop your energy into the most as soon as possible, enhance the functioning of all body systems and launch internal process self-healing. Requires only 5 minutes. But it has a huge impact. Doing it just 3 times a day will replace a full physical training. At the same time, the exercise does not lead to the appearance of fatigue, but only increases the energy reserve.

Consistently doing it for several weeks will lead to progressive changes in your sense of self. The levels of perception and control over internal energy, which were written about in the legends of the masters of Indian yoga, will become available.

The exercise is not really new. We are not reinventing the wheel. It is part of the ancient Tibetan system self-improvement of the body. Its main secret is that it can be performed completely in isolation and combined with any type of physical activity or even with its complete absence. It has no contraindications, does not require knowledge of yoga volumes. Everything you need to know is listed below.
You can do fitness or bodybuilding, and by adding it to your schedule, raise the level of your physical strength revealing the subtlest levels of energy. Or be loaded office worker or a housewife who is completely unable to take care of herself - and apply it throughout the day in order to restore strength and renew herself internally. There are no restrictions.

You will need only a few square meters and preferably a ventilated room.

Clothing should not be restrictive. Ideally, if it is a minimum.
Nobody has to follow you. Concentration and inner peace are needed.

Before doing it, it’s good to warm up a little for a minute or two. Run in place, stretch your joints.

Stand up straight, make sure that there are no places nearby that you can accidentally bump into.

Spread your arms out to the sides, palms down. Start rotating clockwise around its own axis. (If the imaginary clock face under your feet is looking at you). Perform 10-12 turns on average speed. And then 3-5 turns counterclockwise.

Stop. Put your palms together in front of your chest (as in prayer), and fixing your gaze on some point exactly in front of your eyes, inhale and press your palms strongly against each other along with exhalation. Inhale deeply and press again as you exhale. And so several times. This will stop the dizziness and stabilize the unwinding of the energy spheres. This is the stage of energy rotation speed stabilization. Next, lower your arms and just relax and stand straight for a minute or two, looking straight ahead with a defocused gaze.

Such a rotation around itself spins the invisible energy spheres of our body (located at the level of the spine and in the places of the joints), and makes them intensively suck in energy from the surrounding space. The fact is that they constantly rotate and our health and the actual amount of our internal energy depend on how correctly they do it. Rotation may stumble and slow down as a result of experienced mental stress different nature deposited on the subconscious. And this progressively can affect well-being and health in a negative way.

Daily performance of this exercise restarts and stabilizes the rotation of energy spheres, gradually bringing all systems back to normal. You need to do the exercise consistently and daily. It is very good if you can devote time to it 3 times a day: morning, afternoon and evening. Daily practice within a few weeks will definitely bring results. You will see it for yourself, you will feel the inner energy, you will notice that you are no longer tired. In the future, you can reduce the number of approaches to two per day: in the morning and in the evening. And then, when you feel that the condition has returned to normal (“you are constantly at the peak of your form”) - up to once a day. But don't interrupt it completely. Do this exercise prophylactically at least once a day, keeping your energy spheres stable.

The indicated number of revolutions (10-12 + 3-5) is the minimum level to start the practice. Further, the number of revolutions must be increased, and you can also increase the speed of rotation around its axis. The measure of the quantity is the normal state of health: during the rotation and after it, the appearance of nausea and dizziness is unacceptable. If even after the rotation stabilization procedure, you feel nausea - you need to reduce the number of revolutions and rotation speed! You don't have to drive horses. A week or two and gradually your results will invariably creep up. Gradually bring the number of revolutions up to 30 (+ in reverse side 7-8). Again, avoiding discomfort, stopping dizziness in time.

Gradually, the chakras will unwind, grow, come into a harmonious state, and together with them your state will progressively improve. Just remember the following clearly: when rotated clockwise, the spheres open to the set, and when rotated counterclockwise, they close and encapsulate the accumulated. If you mix up where to rotate, you can even lose consciousness. Be careful! First, you open up for energy collection and fill the energy system with particles of energy from the surrounding space; then you close the system and distribute the accumulated, directing it inward into yourself - rotating counterclockwise and then stopping.

This is the whole principle. You need to understand it and competently build your studies on it. Only you can find out how many revolutions you need, and how much is enough for you. At an advanced level, after a month or so, you will be able to rotate freely 30 or more times without any dizziness and nausea and completely forget about them. Over time, you can even increase the number of revolutions to 100 or even more, but the trick is that there is no particular need for this. Enough and smaller efforts, most importantly constant.

The highest level of this exercise that can be achieved is its long execution with a consistent change in the direction of rotation. For example: 30 clockwise - 10 against, then without stopping, again clockwise, then again against. And so several times, back and forth. Chakras are trained in a very hard mode while doing this. If you do it on high speed, while having previously done breathing exercises- you can literally feel how the energy is sucked in and begins to vibrate in the body! This is very high level. And the best part is that you can achieve it yourself! Without gurus and reading volumes of special literature. With this single 5-minute exercise.

The only nuance that will still be useful for you to know is that later, having accumulated energy, your body will begin to give you signs that you will need to distribute it to some lagging, blocked parts of the body. You will want to do some stretching, twisting, joint massage, or just loading the muscles with regular exercises. You want to give excess energy an outlet, perhaps through sports, running, or dancing. Don't resist it. Follow your inner guidance and sensations, and your body will lead you to optimal well-being.