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Shoulder dislocation or subluxation normally occurs as a result of a sudden trauma. Dislocation can also occur from underlying should joint instability, due to previous dislocations. Of all the joints in your body, the shoulder joint is the most frequently dislocated. A shoulder dislocation can occur in an anterior, posterior or inferior direction, with anterior dislocations being most common. Your humerus is forcibly removed from your shoulder socket when you dislocate your shoulder. This can also result in damage to the cartilage surrounding the shoulder joint (the labrum). Occasionally fracture of the humerus or scapular, muscles and ligament tears.
Following a shoulder dislocation, an x-ray is often performed to rule out a fracture and the shoulder is then relocated. This is normally done in A&E and the sooner the shoulder is relocated the better. The initial treatment you will undergo is for the reduction of swelling, muscles spasms and pain. You will wear a sling to immobilise your shoulder. Physiotherapy at this stage is aimed at reducing pain and inflammation. This may include soft tissue release, dry needling and taping to offload the shoulder joint.
Depending on the severity of the dislocation, gentle strengthening can commence. Strengthening of the shoulder is vital to return the shoulder to normal function. Also, prevent recurring shoulder dislocations in the future.
First you will focus on strengthening the rotator cuff muscles. This is the muscle group which, provides most dynamic stability to the shoulder and helps draw the head of the humerus into the socket of the shoulder joint. Your scapula is the anchor that attaches your arm to your chest, so this is why you focus on shoulder blade stability. Your physiotherapist will guide you through a number of stages of shoulder rehabilitation, starting with gentle static contractions and progressing to more dynamic and combined shoulder movements. You can use resistive bands, light weights and body weights to progress your shoulder strength.
Returning to your sport or exercise is your final stage of physiotherapy. You shoulder should be back at 80% of normal function compared to your non-injured shoulder.
Everyone has different expectations and demands for their shoulder that will determine the degree and type of strengthening exercises prescribed by your physiotherapist. Shoulder stability can be further enhanced and improved by working on proprioception, neurodynamics, speed and agility drills that are specific to your sport.