Shoulder dislocation or subluxation normally occurs as a result of a sudden trauma or from underlying should joint instability, due to previous dislocations. Shoulders are the most frequently dislocated joints in the body. A shoulder dislocation can occur in an anterior, posterior or inferior direction, with anterior dislocations being most common. When a dislocation occurs, the head of the humerus is forcibly removed from its socket. 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. Initial treatment is aimed at reducing swelling, muscle spasm, and pain. The shoulder is then immobilised in a sling. 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.

After the shoulder has been rested and immobilised for approximately 7 days, depending on the severity of the dislocation, gentle strengthening can commence. Strengthening of the shoulder is vital to return the shoulder to normal function and prevent recurring shoulder dislocations in the future.

Strengthening is focused firstly on the rotator cuff muscles as 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. Stability of the shoulder blade is also addressed, as your scapula is the stable anchor that attaches your arm to your chest. 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. These exercises can be progressed by using resistive bands, light weights and body weights.

The final stage of physiotherapy treatment following a shoulder dislocation is aimed at returning you to your chosen sport/form of exercise with your shoulder functioning at at least 80% compared to the non-injured side.

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.

If you have experienced a shoulder dislocation, or suffer from recurring shoulder dislocations contact us here to begin your rehabilitation with one of our experienced physiotherapists.