. A manual of therapeutic exercise and massage, designed for the use of physicians, students and masseurs. Fig. 54.—Cane exercise for rotation of arms. For the choice of these various forms of treatment theremust be considered not only the local conditions in and aboutthe bursa but also, as Codman emphasizes, the causes, thenervous and physical conditions of the patient, and, as wemay add, the social conditions and the competency of thesurgeon or the masseur. SUBACROMIAL BURSITIS 227 (a) From our experience we believe that the conservativetreatment by gradual stretching, passive and active exe
. A manual of therapeutic exercise and massage, designed for the use of physicians, students and masseurs. Fig. 54.—Cane exercise for rotation of arms. For the choice of these various forms of treatment theremust be considered not only the local conditions in and aboutthe bursa but also, as Codman emphasizes, the causes, thenervous and physical conditions of the patient, and, as wemay add, the social conditions and the competency of thesurgeon or the masseur. SUBACROMIAL BURSITIS 227 (a) From our experience we believe that the conservativetreatment by gradual stretching, passive and active exercisewith massage and hot air will give good results in very manycases. The general rules are about the same as in the spasticcases only that we should proceed with greater force andenergy. Massage if applied correctly as deep friction over. Fig. 55.—Cane exercise for elevation and rotation of arms,is also of use in postural treatment. This exercise the bursa is of great value, though we cannot reach thedeeper subacromial portion. We apply the treatment bestin the lying position as described above. The operators lefthand steadies the scapula while his right hand conductsthe motions of the arm. After a short treatment with bak-ing and massage we begin generally with rotary motions. 228 SUBACROMIAL BURSITIS liesistive exercise is, as almost always, of greatest importanceeven when the motion is entirely restricted. Its value liesin the proper functioning of the contracted muscles whichin time will exert a decided influence on the stretching, loosen-ing, and final absorption of the adhesions. The order of motions is generally as follows: (1) Rota-tion, outward and inward; (2) anteroposterior motion; (3)abduction; (4) combinations of these three motions. When a certain amount of mobility and control has beenobtained, exercis
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