Rehabilitation Strategies for Right Shoulder Dislocation Recovery

Q: Rehabilitation Strategies for Right Shoulder Dislocation Recovery

Shoulder Dislocation<br>Dear readers： After the reduction of a shoulder dislocation, it is essential to return to the orthopedic clinic for an X-ray examination to confirm the accuracy of the reduction and to check for any associated fractures, as well as to assess for potential

Rehabilitation for Right Scapular Dislocation

Hello Dr.
Chen, 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 only given a triangular bandage without a cast.
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 exercises and movements should I avoid? Are there specific methods and positions that can effectively target the correct muscle groups? Note: I have previously fractured my right upper arm; could this cause any additional issues?

Zhuānkē shēng, 20~29 year old female. Ask Date: 2004/03/10

Dr. Chen Xingyuan reply Orthopedics

Shoulder Dislocation
Dear readers: After the reduction of a shoulder dislocation, it is essential to return to the orthopedic clinic for an X-ray examination to confirm the accuracy of the reduction and to check for any associated fractures, as well as to assess for potential damage to nerves, blood vessels, and rotator cuff muscles.
The most common complication following a shoulder dislocation is re-dislocation, particularly in individuals under the age of twenty, with literature reporting re-dislocation rates as high as 94%.
In contrast, the rate drops to only 14% for those over forty.
Therefore, protection and rehabilitation of the muscles after reduction are particularly important.

After reduction, younger individuals generally require a sling for three to four weeks to immobilize the shoulder joint and limit its activity.
During the first three months post-injury, it is crucial to avoid extreme external rotation and abduction of the shoulder joint (such as in throwing motions) to allow for optimal healing of the injured tissues.
The arm should be positioned in adduction and internal rotation after reduction, and then the range of external rotation and flexion should be gradually increased.
During the protection period, progressive isometric exercises for the muscles, especially the internal rotators, external rotators, deltoid, and scapular stabilizers, should be performed.

I have attached some images of shoulder muscle training for reference; however, it is best to have guidance from a specialized rehabilitation physician or therapist to avoid adverse effects.
If there has been a previous humeral fracture and the healing and shoulder function have returned well, it should not significantly impact recovery.
Wishing you a speedy recovery and safe healing!
Sincerely,
Dr.
Chen

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, it’s important to approach your recovery with a structured rehabilitation plan. Here’s a comprehensive guide on rehabilitation strategies for your right shoulder dislocation recovery.

Initial Phase (Weeks 1-2)
1. Rest and Protection: After the dislocation, it’s essential to allow your shoulder to heal. You’ve already been advised to use a sling, which is a good start. This will help immobilize the shoulder and prevent further injury.

2. Pain Management: Use ice packs on the shoulder for 15-20 minutes several times a day to reduce swelling and pain. Over-the-counter pain relievers like ibuprofen or acetaminophen can also be helpful.

3. Gentle Range of Motion Exercises: Once the initial pain subsides (usually within a week), you can begin gentle range of motion exercises. These might include:
- Pendulum swings: Lean forward and let your arm hang down. Gently swing your arm in small circles.

- Passive range of motion: Use your other arm to help lift your injured arm gently in various directions.

Intermediate Phase (Weeks 3-6)
1. Strengthening Exercises: As you gain more range of motion and your pain decreases, you can start strengthening exercises. Focus on the rotator cuff and shoulder stabilizers. Some effective exercises include:
- Isometric exercises: Press your shoulder against a wall without moving it.

- Resistance band exercises: Use a resistance band to perform external and internal rotation exercises.

- Scapular stabilization exercises: Focus on squeezing your shoulder blades together and holding for a few seconds.

2. Avoid High-Risk Activities: During this phase, avoid activities that involve overhead lifting, heavy weights, or any movements that could put excessive strain on your shoulder.

Advanced Phase (Weeks 7-12)
1. Progressive Strength Training: Gradually increase the intensity of your exercises. You can start using light weights or resistance bands to perform:
- Shoulder presses: Start with light weights and gradually increase as tolerated.

- Lateral raises: Lift weights to the side to strengthen the deltoids.

- Rotator cuff strengthening: Continue with resistance band exercises focusing on the rotator cuff.

2. Functional Training: Begin incorporating functional movements that mimic your daily activities or sports. This might include:
- Push-ups (modified if necessary)
- Plank holds to engage your core and shoulder stabilizers.

Long-Term Maintenance
1. Continued Strengthening: Even after you feel fully recovered, it’s important to maintain a regular strength training routine for your shoulder. This will help prevent future dislocations.

2. Flexibility and Mobility Work: Incorporate stretching and mobility exercises to maintain flexibility in your shoulder joint.

3. Avoiding Risky Movements: Be mindful of movements that could lead to dislocation, especially in sports. Consider wearing a shoulder brace during high-risk activities.

Additional Considerations
- Previous Fracture: Since you mentioned a previous fracture in your upper arm, it’s essential to monitor how this might affect your shoulder’s stability and strength. Consult with your healthcare provider or physical therapist to tailor your rehabilitation program accordingly.

- Professional Guidance: Working with a physical therapist is highly recommended. They can provide personalized exercises, monitor your progress, and ensure you’re using the correct techniques to avoid re-injury.

In conclusion, a structured rehabilitation program focusing on gradual progression from passive to active exercises, combined with strength training and functional movements, will be key to your recovery. Always listen to your body and consult with your healthcare provider if you experience any unusual pain or discomfort during your rehabilitation process.

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