Rehabilitation Strategies for Right Shoulder Dislocation Recovery

Rehabilitation after right scapular dislocation?

Hello, Dr.
Hsu.
On the afternoon of March 4th, I dislocated my right scapula while playing basketball.
Since there were no fractures, it was relocated after being sent to the hospital, and I was not put in a cast but was instead given a triangular bandage.
I am concerned about the possibility of habitual dislocation and want to prevent future recurrences, so I hope to strengthen the muscles around my right shoulder through rehabilitation.
What types of exercises should I use for training? What movements and activities should I avoid? Are there specific exercises and positions that can effectively target the correct muscle groups? Additionally, I have a history of a fracture in my right upper arm; could this cause any other issues?

Gai Huoguo Shoushang de Zhuankesheng, 20~29 year old female. Ask Date: 2004/03/10

Dr. Xu Zhaoren reply Orthopedics

After a shoulder dislocation, manual reduction is typically performed, followed by protection with a triangular bandage or shoulder sling.
Strengthening exercises for the shoulder muscles can begin three weeks later, and it generally takes about 3 to 6 months to achieve the desired strength.
(Illustrations of the exercises will be sent via email.) If you have any further questions, please consult the hospital.

Reply Date: 2004/03/10

More Info

Rehabilitation after a shoulder dislocation is crucial for restoring function and preventing future injuries. Given your situation, where you dislocated your right shoulder while playing basketball, and considering your previous upper arm fracture, it's essential to approach rehabilitation carefully and systematically.

Initial Recovery Phase
After a shoulder dislocation, the initial recovery phase typically involves rest and immobilization. Since you have already had the shoulder reduced and are using a sling, this is a good start. The sling helps to stabilize the shoulder and prevent further injury while it heals. During this phase, it's important to avoid any movements that could stress the shoulder joint, particularly overhead activities or heavy lifting.

Rehabilitation Goals
The primary goals of rehabilitation after a shoulder dislocation include:
1. Pain Management: Control pain and inflammation through rest, ice, and possibly anti-inflammatory medications as prescribed by your doctor.

2. Restoration of Range of Motion (ROM): Gradually regain the ability to move your shoulder through its full range.

3. Strengthening: Strengthen the muscles around the shoulder to provide stability and prevent future dislocations.

4. Functional Training: Prepare for a return to normal activities and sports.

Rehabilitation Exercises
Once your doctor gives you the green light to start rehabilitation, you can begin with gentle range of motion exercises. Here are some recommended exercises:
1. Pendulum Exercises: Lean forward and let your arm hang down. Gently swing your arm in small circles. This helps to maintain mobility without putting too much stress on the shoulder.

2. Wall Climbing: Stand facing a wall and use your fingers to "climb" up the wall. This helps improve shoulder flexion and abduction.

3. Isometric Exercises: These involve contracting the shoulder muscles without moving the joint. For example, press your shoulder against a wall or door frame without moving your arm.

4. Theraband Exercises: Once you have regained some range of motion, you can start using resistance bands to strengthen the shoulder. Focus on external rotation, internal rotation, and scapular retraction exercises.

5. Scapular Stabilization Exercises: Strengthening the muscles around the shoulder blade is crucial. Exercises like scapular squeezes or wall slides can help.

Avoiding Certain Movements
While rehabilitating, it's important to avoid certain movements that could jeopardize your recovery:
- Overhead Lifting: Avoid lifting weights or objects overhead until you have regained sufficient strength and stability.

- Cross-body Movements: Activities that require crossing your arm over your body can stress the shoulder joint.

- High-impact Activities: Sports or activities that involve sudden movements or impacts should be avoided until your shoulder is fully healed.

Considerations for Previous Fractures
Your history of an upper arm fracture may influence your rehabilitation. It’s essential to communicate this to your healthcare provider, as it could affect your range of motion and strength. Your rehabilitation program may need to be adjusted to accommodate any limitations from the previous injury.

Professional Guidance
Engaging with a physical therapist who specializes in shoulder rehabilitation can be incredibly beneficial. They can provide a tailored program based on your specific needs, monitor your progress, and make adjustments as necessary. They can also teach you proper techniques to ensure that you are performing exercises safely and effectively.

Conclusion
In summary, rehabilitation after a shoulder dislocation involves a careful balance of rest, gradual range of motion exercises, and strengthening activities. Avoiding certain movements and seeking professional guidance will help you recover effectively and reduce the risk of future dislocations. Always follow your healthcare provider's recommendations and listen to your body throughout the rehabilitation process. With dedication and the right approach, you can regain strength and function in your shoulder.

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