Understanding and Treating Shoulder Dislocations: From Injury to Full Recovery

Shoulder dislocations are a common and painful injury that can significantly impact daily life. As a physiotherapist, I often see patients struggling with the aftermath of this condition. This blog post aims to provide a comprehensive overview of shoulder dislocations, including their causes, expected recovery time, and what to expect from physiotherapy.

What Causes Shoulder Dislocations?

A shoulder dislocation occurs when the upper arm bone (humerus) pops out of its socket in the shoulder blade (scapula). This part of the shoulder/arm complex is called the glenohumeral joint. The glenohumeral joint, often referred to simply as the shoulder joint, is a ball-and-socket joint where the ball (the head of the humerus) fits into the shallow socket (the glenoid) of the shoulder blade (scapula). This joint allows for a wide range of shoulder movements but is also prone to dislocations due to its anatomical structure and flexibility. Various factors can lead to this injury:

1. Trauma: The most common cause is a sudden impact or trauma, such as a fall, a sports injury, or an accident. Activities that involve significant physical contact, like football or rugby, pose a higher risk.

2. Overuse: Repetitive movements, particularly those involving the arm being lifted above the head, can increase the risk of dislocation. Athletes like swimmers, baseball pitchers, and volleyball players are particularly susceptible.

3. Genetic Factors: Some individuals have inherently looser ligaments, making their joints more prone to dislocations. Conditions like Ehlers-Danlos syndrome can contribute to joint instability.

4. Previous Dislocations: Once a shoulder has been dislocated, it becomes more likely to happen again. The ligaments and muscles may remain stretched or torn, reducing the joint’s stability.

Healing and Recovery Time

The healing process for a shoulder dislocation can vary widely depending on the severity of the injury and the individual’s overall health. Here’s a general timeline for recovery:

1. Initial Phase (0-2 weeks): The primary goal during the first phase is to reduce pain and swelling. Rest, sleep, staying positive (I know, very hard in this stage of recovery) and immobilization using a sling are crucial. Anti-inflammatory medications may be prescribed to manage pain.

2. Subacute Phase (2-6 weeks): As pain decreases, the focus shifts to restoring range of motion and beginning gentle strengthening exercises. Physiotherapy typically starts during this phase.

3. Rehabilitation Phase (6 weeks - 3 months): During this phase, more intensive physiotherapy is conducted to restore full function. Strengthening and stabilization exercises are emphasized.

4. Return to Activity (3 months and beyond): Depending on the individual’s progress and the demands of their activities, they can gradually return to normal activities and sports. Full recovery can take anywhere from 3 to 6+ months, with some individuals requiring up to a year for complete rehabilitation.

Physiotherapy for Shoulder Dislocations

Physiotherapy plays a critical role in the recovery process for shoulder dislocations. Here’s what you can expect during the different phases of physiotherapy:

1. Initial Phase:

   • Immobilization Guidance: Advice on how to properly use slings or braces to immobilize the shoulder and prevent further injury.

2. Subacute Phase:

   • Range of Motion Exercises: Gentle passive and active-assisted exercises to restore mobility. These may include pendulum exercises and passive range of motion exercises.

   • Isometric Exercises: These exercises involve contracting the muscles without moving the joint, helping to maintain muscle strength without straining the injury.

3. Rehabilitation Phase:

   • Strengthening Exercises: Focused on the rotator cuff muscles and scapular stabilizers. Exercises will include the use of resistance bands, weights, cables and in some cases the barbell.

   • Proprioception Training: Activities designed to improve the body’s ability to sense the position of the shoulder joint, enhancing stability and coordination.

4. Return to Activity Phase:

   • Sport-Specific Training: For athletes, physiotherapy will include exercises and drills that mimic the movements of their specific sport to ensure a safe return to play.

   • Functional Exercises: These exercises aim to restore the shoulder’s ability to perform daily tasks, such as reaching, lifting, and carrying.

Conclusion

Recovering from a shoulder dislocation requires time, patience, and a structured rehabilitation program. Understanding the causes, expected healing timeline, and the role of physiotherapy can help individuals navigate their recovery more effectively. If you or someone you know is dealing with a shoulder dislocation, seeking professional physiotherapy can significantly help in regaining strength, stability, and function in the shoulder joint. Always consult with a physiotherapist to tailor the rehabilitation process to your specific needs and circumstances.

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Bri Hicks Physio & Performance is dedicated to providing evidence based physiotherapy care.

Have you dislocated your shoulder? Book a Physiotherapy appointment today or reach out if you have any questions.