Understanding Shoulder Dislocation and the Role of Physiotherapy in Recovery

Shoulder Dislocation Physio

Shoulder dislocations are the most common joint dislocation and account for more than 50% of all dislocations treated in hospitals. Although they can initially be very painful and cause a loss of confidence in the joint, with proper treatment and shoulder dislocation physio rehabilitation most people can expect a full recovery and a return to their regular activities.

What is a shoulder dislocation?

A shoulder dislocation occurs when the upper arm bone, the humerus, comes out of the shoulder socket known as the glenoid. The shoulder is more vulnerable to dislocations due to its high level of mobility.

There are three main types of shoulder dislocations:

• Anterior dislocations: These are the most common types of dislocation. Anterior dislocations occur when the head of the humerus moves forward out of the socket.
• Posterior dislocations: These occur when the head of the humerus moves backward, often due to trauma, or in some cases posterior dislocations can happen when a person has a seizure.
• Inferior dislocations: These are rare and usually occur due to extreme force pulling the arm downward.

How does a shoulder dislocation happen?

Shoulder dislocations can result from:

• Falling, particularly onto an outstretched arm.
• Direct impact to the joint, such as when playing contact sports.
• Sudden pulling or twisting motions.
• Repetitive strain with prior shoulder instability due to overstretched or loose ligaments.

Some people are more prone to shoulder dislocations due to genetic predisposition causing hypermobility. Genetic markers have been identified in playing a role in causing people to be more prone to shoulder dislocations. Some conditions such as Ehler’s Danlos can cause laxity of the ligaments and hypermobility of the joints also leading to a higher risk of dislocations. People also have variations in the shape and size of the bones of the shoulder, such as a shallow capsule, making the joint more prone to instability.

What are the signs and symptoms of shoulder dislocation?

The following symptoms are usually present with shoulder dislocations:

• Visible deformity
• Intense pain and inability to move the shoulder through normal range of motion
• Tenderness to touch around the shoulder
• Swelling and bruising may be present
• Some people may experience numbness or tingling in the arm or hand

In cases of a subluxation, the head of the shoulder may only partially come out of the joint and relocate without medical assistance. However, with a full dislocation, medical attention is necessary to relocate the joint.

What precautions should I take immediately after a shoulder dislocation?

• After a shoulder dislocation, once the joint has been relocated, it will be necessary to wear a sling to prevent dislocating the joint again and allow the ligaments and muscles to rest and heal. A medical professional such as a physiotherapist or doctor will be able to advise you on the exact length of time, but often a sling is required for at least a week.
• Ice can be useful in the first few days after a dislocation to help with managing pain and inflammation.
• If necessary, over-the-counter medication such as ibuprofen or paracetamol can be used to help manage pain.

How Can Shoulder Dislocation Physio Help?

After a shoulder dislocation most people will feel fearful when resuming movement and will require reassurance and guidance on progressing their exercises and rehabilitation. It is important in the early stages after a shoulder dislocation to begin range of motion exercises for your elbow and to do grip strengthening exercises for your hand and wrist to prevent loss of muscle mass, joint stiffness, and muscle tension.

It is essential to rebuild strength in muscles around the shoulder after the period of immobilisation as your shoulder will require muscle stability and strength to prevent reinjury. Proprioceptive exercises are also important to do to help your joint to move properly with functional activities.

A shoulder dislocation physio will be able to progress your exercises safely to gradually improve range of motion, strength, proprioception, and stability to achieve an optimal outcome while avoiding further injury. Physiotherapy will also help you to build confidence in your shoulder to allow you to return to sports and hobbies.

When is surgery necessary?

Most of the time surgery is not necessary after a shoulder dislocation. However, in some cases where there have been recurrent dislocations, particularly in younger people who are involved in contact sports, surgery may be required.

Conclusion

Early intervention and consistent rehabilitation are key to regaining full shoulder function and returning to daily activities with confidence. Understanding the causes, symptoms, and treatment options for your shoulder dislocation is essential for optimal recovery. Whether it’s the result of trauma, sports, or joint instability, early diagnosis and appropriate treatment are key. With appropriate rehabilitation, most individuals can regain full function and return to their desired activity.