CA2693753A1

CA2693753A1 - Shoulder stretcher and method of use

Info

Publication number: CA2693753A1
Application number: CA2693753A
Authority: CA
Inventors: Peter Scott Borden
Original assignee: Individual
Current assignee: Individual
Priority date: 2007-07-12
Filing date: 2008-06-11
Publication date: 2009-01-15
Also published as: WO2009009247A1

Abstract

A human shoulder stretcher and method of use for gradual, progressive posterior capsular stretching to rehabilitate the shoulder, in particular to address tightness of the posterior capsule of the glenohumeral joint through use of a lever arm and ratcheting mechanism that permits a patient to stretch his or her shoulder without the need for a therapist present.

Description

SHOULDER STRETCHER AND METHOD OF USE

FIELD OF INVENTION

[0001] The invention relates generally to a device for use in rehabilitation of the shoulder of a human, in particular to address tightness of the posterior capsule of the glenohumeral joint, i. e. , the human shoulder.

BACKGROUND OF INVENTION

[0002] Tightness of the posterior capsule of the glenohumeral joint is a common problem that occurs secondary to a minor shoulder problem. It is a significant problem to athletes who throw, to post-operative patients having had shoulder surgery and to people who suffer from impingement syndrome of the shoulder, the most common source of shoulder pain.

[0003] Devices and methods for shoulder stretching are known. For example, United States Patent 5,520,615 ("the `615 patent") describes a pulley system included in a self-assertive shoulder stretching and rotation machine wherein a supine person's forearm is secured to a forearm support that is attached to a horizontal support movable by the supine person's pulling on a rope. United States Patent 6,007,500 ("the `500 patent") describes a belt and pulley system included in a rotator cuff stretching machine with pivoting members that provide for simultaneously stretching of the rotator cuff, shoulder and elbow in selective upper arm positions of yaw and pitch angles and selective elbow positions of flexion or extension. The `500 patent machine includes upper and forearm assemblies that are pivotably joined through a bearing assembly and requires the patient to sit upright. The assembly has a rotational capacity of 360 degrees and is attached to a vertical support that rotates in horizontal yaw on a vertical yaw pivot pin. United States Patent 6,569,067 ("the `067 patent") describes a device that elevates the elbow off of the torso and abducts the arm for rehabilitating the shoulder. It includes a first C-shaped member for supporting the extremity of the patient and a second C-shaped member for engaging the torso of the patient.

SUMMARY OF INVENTION

[0004] The shoulder stretcher and methods of use described herein provide the first known device that functions to permit, without a physical therapist or other assistant, posterior capsular stretching of the human shoulder through use of a mechanical ratcheting device. The device includes a base or rigid support, an arm strap, and a lever arm that is rotatably fastened to the base, and preferably includes a ratcheting mechanism that prevents reverse rotation except upon operation of a ratchet release. The mechanical stretching device functions to stretch human shoulders and is preferably for use in shoulder rehabilitation and prevention of posterior capsular tightness and capsulitis. It can be used for self-stretching by a patient, and preferably incorporates a dial type ratcheting mechanism for staged stretching of the shoulder. It can be used for posterior capsule stretching and in its reverse position or orientation can be used for external rotation stretching. The shoulder stretching apparatuses and methods described herein function to provide for progressive stretching of the shoulder joint in both internal and external rotation. The apparatus provides a person with the capability to maximally stretch the shoulder without an assistant or therapist while slowly advancing range of motion in a desired plane. It allows the person to gradually advance the rotation of his or her shoulder capsule through a home therapy program. These functions and capabilities are accomplished by a strap system that stabilizes the arm and elbow to a firm platform while the forearm is progressively advanced in the desired direction of shoulder rotation by means of a lever arm. In one embodiment the ratcheting mechanism allows for forward stretching of the forearm without the ability to reverse or go backwards unless a release mechanism is activated. The structure of this embodiment provides the user with the ability to stretch his or her shoulder joint over an extended period and at his or her own pace.

[0005] During use in stretching the injured shoulder's forearm is positioned adjacent to, or rested against the lever arm, and the user's forearm is strapped to or otherwise stabilized to the lever arm. The user's upper arm is strapped or otherwise stabilized to the base. Then the device's lever arm and the user's forearm are preferably advanced, or rotated preferably by the patient's other arm. As the forearm of the injured shoulder is advanced, the ratchet mechanism clicks and holds its place with each advancing increment of rotation to prevent backward or reverse motion of the forearm. The patient can stop the rotation at any increment or increments of rotation to rest the shoulder at a desired degree or increment of rotation and stretching. After each rest period, the patient can then continue the sequence of rotation, rest; rotation, rest, etc., until a desired degree of stretching is reached for a given exercise or therapy session. During this sequential series of motions and rests the arm strap holds or stabilizes the patient's upper arm to the base, so that that shoulder does not lift off of the base. Thus, during use the arm strap secures the patient's arm to the base in order to prevent the upper arm from lifting off of the base, as the forearm strap is advanced toward the base. Once the shoulder has been stretched adequately, or at any other time during the therapy session, a ratchet release actuator can be pressed or otherwise activated to release the ratchet. Releasing the ratchet mechanism permits reverse rotation, or backwards movement of the lever arm. The ratchet mechanism and lever arm preferably permit 180 of rotation of the lever arm/forearm rest. Thus, the device may be used for right and left shoulder rehabilitation, and for progressive, staged stretching of the shoulder at a pace and to the extent desired by the patient.

[0006] These and other embodiments, features, aspects, and advantages of the invention will become better understood with regard to the following description, appended claims and accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

[0007] The foregoing aspects and the attendant advantages of the present invention will become more readily appreciated by reference to the following detailed description, when taken in conjunction with the accompanying drawings, wherein:

[0008] Figure 1 is a perspective view of a preferred embodiment shoulder stretcher;

[0009] Figure 2 is a perspective view of the Figure 1 embodiment in reverse orientation;

[0010] Figure 3 is a top view of the stretcher as shown in Figure 2;

[0011] Figure 4 is a front view of the stretcher as shown in Figure 2;

[0012] Figure 5 is a side view of the stretcher as shown in Figure 2;

[0013] Figure 6 is a view of the ratchet mechanism of the Figure 1 embodiment with the housing shown in dashed lines to expose the interior ratchet mechanism;

[0014] Figure 7 is a view of the Figure 1 embodiment including a drawing of a user as would be orientated during a shoulder stretching operation; and, [0015] Figure 8 is a view of an alternate embodiment showing a lever arm that includes a forearm rest.

[0016] Reference symbols or names are used in the Figures to indicate certain components, aspects or features shown therein. Reference symbols common to more than one Figure indicate like components, aspects or features shown therein.

DETAILED DESCRIPTION

With reference to Figures 1-8 preferred embodiments of the mechanical shoulder stretcher device and methods of their use will be described. Shoulder stretcher 20 includes a base or rigid support 22, arm strap 24, elbow strap 26, lever arm 30, ratchet mechanism 32 and ratchet release actuator 34. Shoulder stretcher 20 functions to stretch the posterior capsule without need for a physical therapist or other assistant. In other words, the person with the injured shoulder, i.e., the patient, can operate the device by himself or herself. The attendant advantages to such a self-use device include more flexibility in scheduling therapy sessions, reduced costs, and increased number of therapy sessions because no appointment with a physical therapist is needed. The shoulder stretcher 20 is intended to be used for shoulder rehabilitation and prevention of posterior capsular tightness or capsulitis, i.e., inflammation of the shoulder capsule.

[0017] Base 22 is preferably a padded board and functions to provide a stable platform for the user's torso. The board need not be padded. While the board shown in the Figure 1 embodiment is generally rectangular, having a longitudinal centerline 21, it may be of virtually any shape, and be made of virtually any material so long as it provides a platform sufficiently stable to facilitate stretching of the shoulder in accordance with the methods of stretching described herein. Also, the size of the board may vary, in accordance with the size of the user, i.e., a relatively small board for a small user such as a child, and a relatively large board for a larger user, such as a professional basketball, football or baseball player.

The arm strap or belt 24 is preferably a conventional strap that may be made of leather, natural fibers or synthetic material. The arm strap 24 preferably extends from two slots in the base that are preferably equidistant from the centerline 21 and functions to provide a firm, stable securing of the patient's upper arm to the base 22 with sufficient restraining force to prevent the upper arm from lifting off of the patient's proximal shoulder during use of the device. By the term upper arm is meant that part of the arm surrounding the humerus bone. Preferably a single strap is used, and the strap is of a sufficient width and placed in a position on the base so that during use it functions to hold the upper arm, from the distal end of the humerus bone to the proximal end of the humerus bone in a fixed position on or near to the base. Preferably the arm strap and the slots are constructed and adapted to be capable of movement long the centerline 21 to accommodate arms of different lengths. This allows for variations in size of the patients' arm length between the elbow and the shoulder.
During use it is important that this strap be tightened enough to hold down the shoulder/upper arm so that the shoulder touches the base during use of the device, or alternatively, holds the shoulder/upper arm close to the base during use of the device. When patient's the arm is stretched in this device it has a tendency to rise superiorly, and thus the arm strap functions to prevent this rise. As will be apparent to those skilled in this art, one or more arm straps may be used. Also, various materials of construction may be used, such as for example, leather, natural fiber cloth, and synthetic materials.

[0018] The arm strap preferably has Velcro brand or some other brand of loop and hook type fastener to maintain the strap in a tightened position. Alternatively, other conventional belt- fastening devices may be used. The arm strap 24 may be made of virtually any material and may be fastened in a tight position with virtually any type of fastener, including a conventional knot, so long as the strap is capable of functioning for its intended purpose.
Optionally, the device may be made to have the arm strap positionable at various locations along centerline 21, as shown in Figure 3. Such a construction is believed to be within the skill of a person of ordinary skill in this field, and could include, optionally, for example relatively long slots 44, 46 that would extend in the same direction as line 21, but of course be longer than the slots 44, 46 illustrated in Figure 3. Use of such a positionable arm strap would of course enable a single device to be used by patients of a wide range of sizes.

[0019] As shown in Figures 1-5 and 7-8, a second strap 26 also provides for holding the upper arm down on or near to the base during operation. As shown here the second strap 26 operates primarily on the distal end of the upper arm for the injured shoulder. Second arm strap 26 is preferably a conventional strap, much like the first arm strap 24, and is used to secure the elbow and lower part of the upper arm to the base during use. In one embodiment the second arm strap 26 is preferably provided with a reinforcing frame 28 having opposed sides that are equidistant from the centerline 21, and that function to provide additional structure to secure the patient's elbow to the base so that the elbow does not lift off the base during use. As described above, use of two arm straps is optional. In one embodiment, a single arm strap may be used so long as it functions to restrain movement of the shoulder away from the base during operation of the device.

[0020] Telescoping lever arm 30 includes at one end a handle and at its other end a connection to the axle of ratchet mechanism 32. The axle extends along the centerline 21, at a relatively short distance above the centerline 21, and provides an axis of rotation for the ratchet mechanism 32 and lever arm through planes that are perpendicular to the axis of rotation. In Figures 1, 3 and 4 a plane through which the lever arm rotates is shown as plane A, and the plane through which the ratchet wheel or gear rotates is shown as plane B. Planes A and B are generally perpendicular to the plane in which the base 22 lies and they are also generally perpendicular to the axis of rotation of the ratchet mechanism. As may be appreciated, the plane in which the ratchet mechanism rotates, plane B, is parallel to the plane in which the lever arm rotates, i.e., plane A. The conventional telescoping arm provides for and accommodates a range of arm lengths. The handle extends back toward the patient and during use of the device may be gripped by the patient's hand or used as a support for the patient's hand, either front side or back side. With reference to Figures 6 and 8, the ratchet mechanism includes a gear or toothed wheel positioned inside of a housing and fastened about the axle for rotation in either the clockwise direction or counterclockwise direction. A
U-shaped brake 44 is rotatingly attached to one side of the housing, and extends exterior to the housing in the form of a release and reverse lever 34. As shown in Figure 6, the lever 34 operates as a brake against rotation in a clockwise direction. By rotating the lever 34 in a clockwise direction the brake 44 is also rotated clockwise to a position against the whee142 at which it operates as a brake against counterclockwise direction. The housing is fastened to the base via conventional fasteners 36, such as screws, rivets, staples, nails, glue or any other means so long as they function to keep the housing fastened to the base.
Figure 7 illustrates the positioning of a user's body, particularly the shoulder, upper arm, forearm and hand in relation to the various parts of the shoulder stretcher mechanism.

[0021] As shown in Figure 8, the device may be provided with an optional forearm rest 48 positioned on the lever arm 30. The forearm rest functions to provide a stable support for the forearm. The end of the lever arm 30 distal from the ratchet mechanism 32 is formed into a "U" shape, with the closed end of the "U" forming a handgrip 50. The handgrip may be made of any of a variety of materials, such as cloth, a rubber or elastomeric material, or an absorbent material. A sling 52 is positioned on the legs of the "U" and extends between the "U" to form and function as a forearm rest. A strap 54 is preferably fastened to one of the legs of the "U" and extends across, and is attachable at the opposite let of the "U". The strap 54 functions to provide a restraint for the forearm in one direction of rotation, and as the forearm rest in the opposite direction of rotation. The strap 54 is preferably fastened to one leg with a hook and loop type fastener. Various types of materials may be used for, and various techniques may be used to fasten the forearm sling and forearm strap to the lever arm 30. In yet another alternate embodiment, the lever arm may be in the form of a horseshoe with elongated legs of the same length, the distal ends of which are fastened to the axle of the ratchet mechanism. In this alternate embodiment webbing, a solid surface or some other material extends between the elongated legs and then along the length of the lever arm to function as a forearm rest or support. The elongated horseshoe lever arm may also be of a telescoping design capable of adjustment to accommodate arms of different length.

[0022] The shoulder stretcher is designed to address tightness of the posterior capsule of the glenohumeral joint (shoulder) that is an extremely common problem that occurs secondary to a minor shoulder problem. It is a real problem in throwing athletes, post-operative patients, and patients with a diagnosis of impingement syndrome of the shoulder, the most common source of shoulder pain. The shoulder stretcher is designed primarily for posterior capsule stretching, although it also could be used for internal stretching simply by reversing the orientation of the user with respect to the device during use.
During use the patient lies on the side of the pathology, and then straps the arm into the device. Next, using the ratchet mechanism, the arm is bent towards the floor in the vicinity of the hip on the same side of the shoulder problem. This bending is in general a rotation with the upper arm as the axis of rotation, and with the upper arm extending in general along the base centerline 21.
Thus, in general the axis of rotation of the upper arm and the axis of rotation of the ratchet mechanism are parallel, and as shown in Figure 1 preferably would also be parallel to the centerline 21. The device is designed primarily for rotation in one direction that stretches the posterior capsule. The reason for 180 degrees of motion is to allow for right or left use with the same unit. Thus, for each arm the device can be rotated in the clockwise direction as well as in the counterclockwise direction. For example, as shown in Figure 7 the user's right arm is positioned for rotation in the counter-clockwise direction, so that posterior capsule stretching takes place during the rotation. When the device is used on the left arm, the direction of rotation is clockwise for posterior capsule stretching. When during use the right arm is rotated in the clockwise direction the interior stretching takes place.

[0023] When stretching the shoulder with this devise, the patient lies on the platform or base, preferably padded and made of a plastic material, then turns on the side of the injured shoulder. The strap (or straps if more than one strap is used) is placed across the arm between the elbow and the shoulder is tightened sufficiently to prevent the upper arm from lifting up or rising during rotation of the arm of the user and lever arm of the device. The optional forearm rest, if used, provides a surface on which the forearm rests while the hand grips the handgrip of the lever arm for support. The patient then uses the other arm to pull or rotate the lever arm and arm towards the floor adjacent to the hip. As the forearm rest advances or rotates incrementally toward the floor, as each increment of rotation is accomplished, the ratchet mechanism prevents reverse rotation of the forearm rest back toward its starting position. With this ratcheting capability, the patient can sequentially rotate the arm to a first desired rotational position, then stop and rest the shoulder with the lever arm locked in that position. After resting a desired period, the patient can resume rotation until a second desired rotational position is achieved, and again stop rotation to rest the shoulder.
The patent can then continue the sequence of rotation, rest, rotation, rest, rotation, etc., until a final desired position of stretching is achieved for a given therapy session.
Then the patent can release the ratchet, so that the lever arm and patient's arm can be reverse rotated back to the starting position.

[0024] By this sequential action and motion, the patient sequentially stretches the posterior capsule and holds it in a stretched position. The user rotates the lever arm to a position that can be tolerated, and then waits for the shoulder to stretch.
After a while, the shoulder is stretched and the user can advance, or further rotate the level arm, and the attached forearm of the user to further stretch the shoulder. This cycle or sequence of rotation, rest; further rotation, rest; further rotation, etc., takes place for a desired number of times at the choice of the user during each session. The user also chooses the number of sessions, preferably under the direction of his or her treating physician. The sessions and stretching operations are continued until the shoulder capsule has been stretched sufficient to return the shoulder to normal ranges of motion, or otherwise to a position of acceptable stretching for that particular patient. During each stretching session, once the shoulder has been stretched adequately, or to some desired position of rotation for that session, the release button is pressed to release the ratchet brake, and to permit reverse rotation of the forearm rest and the ratchet mechanism to their original, starting positions. Thus, the patient may gradually and progressively stretch his or her shoulder joint in both internal and external rotation.

[0025] Although specific embodiments of the invention have been described, various modifications, alterations, alternative constructions, and equivalents are also encompassed within the scope of the invention.

[0026] The specification and drawings are, accordingly, to be regarded in an illustrative rather than a restrictive sense. It will, however, be evident that additions, subtractions, deletions, and other modifications and changes may be made thereunto without departing from the broader spirit and scope of the invention as set forth in the claims.

Claims

1. A human shoulder posterior capsular stretching device comprising:

a base having a predetermined length, width and longitudinal centerline;

a first arm strap positioned on the base, having a predetermined length and width, and adapted to hold an upper arm of the user against the base during use;

a ratchet mechanism positioned on the base, the ratchet mechanism having an axle with an axis of rotation about a horizontal line lying in a vertical plane passing through the centerline of the base;

a lever arm having a first end fastened to the ratchet mechanism axle and adapted to rotate about the axis of rotation of the ratchet mechanism, a second end having a handle, and an adjustable length; and, a second arm strap positioned on the base between the first arm strap and the ratchet mechanism, having a predetermined length and width, and adapted to hold the upper arm of a human user against the base and at the distal end of the upper arm;

whereby the posterior capsule of the human shoulder may be stretched upon rotation of the lever arm.

2. The shoulder stretcher of claim 1, wherein said ratchet mechanism includes a ratchet release.

3. A method of posterior capsule stretching of a shoulder of a person in a desired plane comprising:

providing a base having a predetermined length, width and longitudinal centerline;
providing a first arm strap positioned on the base, having a predetermined length and width, and adapted to hold against the base the person's upper arm located on the same side of the person's body as the shoulder;

providing a ratchet mechanism positioned on the base, the ratchet mechanism having an axle with an axis of rotation about a horizontal line lying in a vertical plane passing through the centerline of the base and parallel to the desired plane;

providing a release mechanism for the ratchet mechanism;

providing a lever arm having a first end fastened to the axle of the ratchet mechanism, a second end having a handle, and an adjustable length; and, providing a second arm strap positioned on the base between the first arm strap and the ratchet mechanism, having a predetermined length and width, and adapted to hold the upper part of the arm against the base during use;

strapping the upper arm in the first arm strap and in the second arm strap with sufficient tightness to prevent the upper arm from lifting from the base during stretching;
gripping the lever arm handle;

progressively stretching the shoulder by sequential rotation of the lever arm and interruption of rotation comprising:

rotating the lever arm to rotate the shoulder in the desired plane from a first position to a second position, thereby stretching the posterior capsule of the shoulder;

sustaining the shoulder in the first position for a first period by stopping rotating the lever arm;

rotating the lever arm to rotate the shoulder in the desired plane from the second position to a third position, thereby further stretching the posterior capsule of the shoulder;
and, sustaining the shoulder in the third position for a second period.

4. The method of claim 3 including repeating the sequential rotation of the lever arm for a desired number of periods.

5. The method of claim 4 including activating the release mechanism after the desired number of periods.