. A manual of therapeutic exercise and massage, designed for the use of physicians, students and masseurs. iples. We do not see any clearer way than to follow again Cod-mans description, with which we agree in principle. 1. In the first, the acute or spasmodic type, the mainindications are: ^the patients comfort and the avoidanceof adhesions. Rest is best obtained by keeping the armin abducted position; the patient may be seated with atable at his side and the abducted arm laid on a pillow onthe table. During the night the arm is supported on apillow placed with its long axis at right angles w
. A manual of therapeutic exercise and massage, designed for the use of physicians, students and masseurs. iples. We do not see any clearer way than to follow again Cod-mans description, with which we agree in principle. 1. In the first, the acute or spasmodic type, the mainindications are: ^the patients comfort and the avoidanceof adhesions. Rest is best obtained by keeping the armin abducted position; the patient may be seated with atable at his side and the abducted arm laid on a pillow onthe table. During the night the arm is supported on apillow placed with its long axis at right angles with thepatients body as he lies on his back. When the patient isup he may wear the arm in a sling, but should be advised tolet the arm occasionally swing by his side or rest it on a table(Fig. 50). Massage applied to adjacent muscles and subcu-taneous tissue may be of value, but it should not be applied SUBACROMIAL BURSITIS 219 to the region of the bursa directly. As in all such acutecases, joints, bursie or other structures being affected, tooextensive and heroic treatment is contraindicated and will. Fig. oO.—All artive-passive exercise dexised by Codiiiaii. The patientleans forward and has his arm drop passively. This movement is oftenpossible in subacromial bursitis where an active motion at the same angleis not possible. do more harm than good. When the acute stage has passedgentle exercise may be done. For such cases the pendulumand other Zander apparatus are of decided value, thoughnot necessary. 220 SUBACROMIAL BURSITIS 2. In the subacute or adherent type the treatment out-lined under No. 1 will suffice as long as the adhesions areplastic. Even then the limitation may be of a chiefly spasticnature. But here a somewhat more active course is indi-cated. These are the cases where much benefit can bederived from a rational treatment which is given under full
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