Shoulder dislocation is the displacement of the humerus head out of its socket due to a force sufficient to overcome the binding strength of the glenohumeral ligament. Shoulder dislocation restricts the arm’s range of motion and affects daily activities reducing the quality of life.
Besides correcting the malalignment of the joint with the help of physical therapy, the shoulder needs rehabilitation to restore its intrinsic stability. Rehabilitation is vital in preventing recurrent shoulder instability, which results in deformities.
According to a 2016 study, the rate of recurrent dislocation in athletes who skipped rehabilitation and returned to their routine after the first dislocation is 37 to 90%.
Understanding Shoulder Dislocation
Before discussing the recovery and rehabilitation process, let’s first understand some critical factors concerning the basics of shoulder dislocation.
- Anatomy of the Shoulder Joint
The shoulder articulates four joints between three bones, the humerus, scapula and clavicle. Shoulder dislocation occurs at one of the four joints called the glenohumeral joint, which connects the glenoid fossa of the scapula with one-third of the humeral head. The joint aids the movement of the upper arm, including.
- Abduction
- Lateral flexion
- Lateral extension
- External rotation
- Internal rotation
- Transverse flexion or horizontal adduction
- Transverse extension or horizontal abduction
However, the joints are intrinsically unstable and depend on the muscles that orchestrate the movement of the arm about the shoulder. Important muscles are the rotator cuff, biceps brachii and triceps.
Concerning stabilisation of shoulder joints, the muscles are of two classes: static and dynamic stabilisers. Static stabilisers protect the joints while in rest, whereas dynamic counterparts play the role while the arm is in motion.
- Causes of Shoulder Dislocation
The dislocation occurs due to a strong force that draws the head of the humerus out of its socket in the shoulder blade. The common source of the impact is as follows.
- Contact sports injuries.
- Road traffic accidents
- Traumatic incidents
- Fall onto a hard surface.
Now, let’s discuss the recovery process for shoulder dislocation, which is discussed in detail below.
Preparing for Recovery
Shoulder dislocation’s recovery process involves certain measures you should follow. Below are some measures concerning the whole procedure.
- Diagnosis and Evaluation
X-ray of the shoulder is a common preliminary examination to visualise the relative confirmation of constituent bones. Further, doctors may order MRIs to detect abnormalities in the shoulder muscles. Electromyography or nerve conduction studies help identify axillary nerve injury, which occurs in about 40% of shoulder dislocations.
- Planning for Physical Therapy and Rehabilitation
Physical therapists evaluate patients thoroughly before devising a dislocated shoulder physical therapy protocol. It depends on the following factors.
- The goal of patients concerning the activities they intend to perform after recovery.
- Status of the shoulder regarding pain and range of motion
- Radiological scans indicate the extent of damage incurred.
- Setting Realistic Goals
The primary goal of rehabilitation is restoring a full or predetermined range of motion according to the patient’s needs. Further, rehabilitation programs aim to preserve long-term joint stability to prevent the recurrence of dislocation.
Physical Therapy for Shoulder Dislocation Recovery
Physical therapy is usually considered one of the best shoulder dislocation recovery procedures. So, without further ado, let’s discuss the various components of physiotherapy treatment for shoulder dislocation discussed in detail below.
- Passive Range of Motion exercises
Passive exercises are the primary shoulder dislocation rehab exercises. They involve moving the shoulder and arm in determined directions with an external force.
Patients do not need to use their muscles or may be unable to move due to pain. They release the stiffness in the joint and gradually reduce pain upon the movement of arms.
- Active Range of Motion exercises
As the patient begins to feel less or no pain in passive motion, physical therapists guide them to move their arms using muscle strength. The exercise regimen starts with simple movements such as
- Pendulum movement with leaned back,
- Standing arm stretching,
- Shoulder elevation lying on the back,
- External and internal rotation
- Shoulder extension,
- Shoulder elevation with a pulley.
The number of sessions, frequency, and intensity of the exercises depend on the injury and the patient’s response to the therapy.
- Strengthening Exercises
They help extend the shoulder’s range of motion and weight-bearing capacity. Therapists begin this phase after the pain diminishes completely. They are as follows.
- Isometric exercises: they work out muscles without moving the joints.
- Rotator cuff exercises
- Wobble board exercises
- Rebound exercises.
- Pain Management Techniques
Cold therapy after sessions helps reduce pain and discomfort. Pulsed electric stimulation improves blood circulation, reduces pain, and promotes healing.
Rehabilitation for Shoulder Dislocation Recovery
A shoulder dislocation is a common injury due to trauma, such as a fall, sports-related activities, or a car accident. Rehabilitation is a crucial aspect of recovering from a shoulder dislocation, as it helps to alleviate pain, improve the range of motion, and restore strength to the affected area.
Some modalities, techniques, programs, precautions, and guidelines may be recommended as part of a shoulder dislocation rehabilitation program:
- Modalities for Pain Relief and Tissue Healing
Ice Therapy: Applying ice to the affected area can help to reduce pain and swelling.
Heat Therapy: Applying heat to the affected area can help to promote blood flow and tissue healing.
Ultrasound Therapy: Ultrasound therapy uses high-frequency sound waves to stimulate blood flow and promote tissue healing.
Electrical Stimulation: Electrical stimulation involves using low-level electrical currents to stimulate the muscles and promote healing.
- Manual Therapy Techniques
Joint Mobilisation: Joint mobilization involves gentle, passive movements to improve joint mobility and reduce pain.
Soft Tissue Mobilisation: Soft tissue mobilisation involves using manual techniques, such as massage or myofascial release, to improve tissue mobility and reduce pain.
Stretching Exercises: Stretching exercises can help to improve the range of motion and reduce stiffness in the affected area.
Strengthening Exercises: Strengthening exercises can help to restore strength to the affected area and improve overall function.
- Return to Sport/Activity Program
A gradual return to activity program is recommended to help ensure that the affected area is fully healed and strong enough to withstand the demands of sports or other physical activities.
The program may include specific exercises or activities designed to mimic the movements required in the particular sport or activity.
- Precautions and Guidelines
It is important to follow any precautions or guidelines the healthcare professional provides to avoid re-injury or further damage to the affected area. Avoid overhead activities or lifting heavy weights until cleared by a healthcare professional.
Conclusion
Throughout this guide, we’ve discussed shoulder dislocations, their causes, symptoms, and treatments. We’ve covered the different types of dislocations, the importance of seeking medical attention, and how to manage pain and discomfort during recovery. We’ve also talked about exercises and physical therapy that can aid in the healing process.
If you’ve experienced shoulder dislocation, seeking professional help is important. A medical professional can help diagnose your injury and provide treatment recommendations to help you recover quickly and safely. Remember, your health is important, and seeking professional help is a sign of strength, not weakness.