Shoulder Dislocation

SYMPTOMS MAY INCLUDE:

• Significant pain at the shoulder joint. 
• Decreased range of motion at the shoulder joint. 
• Swelling and tenderness. 
• Numbness or tingling sensation. 
• Loss of shoulder strength
• A popping or clicking sound with movement of shoulder.

SHORT TERM

It is vital a dislocated shoulder requires prompt reduction in order to return the arm bone (humerus) to the socket.

DIAGNOSE AND EDUCATION

At the Injury Clinic, your physiotherapist will look to assess and appropriately diagnose what structures of the shoulder joint are damaged.

Physiotherapists will provide education on the rehabilitation pathway and collaboratively to provide a specific and targeted treatment plan.

IMAGING REFERRAL 

Referral for imaging such as MRI may be indicated to assist in determining the severity of damage at the tissues of the shoulder joint.

NON-STEROIDAL ANTI-INFLAMMATORIES

Anti-inflammatories can aid recovery and settle the inflammatory process. Always consult your GP or pharmacist before taking any medication. 

It is also necessary to consider principles of PEACE & LOVE.  Generally, it is recommended the consumption of anti-inflammatory medication should be avoided within the first 48-72 hours of an acute shoulder dislocation.

SOFT TISSUE TECHNIQUES/DRY NEEDLING

These modalities can assist with soreness and discomfort in surrounding tissues. 

Such techniques look to relieve tightness of not only the affected site, but also certain muscles that may be utilised as an adaptive strategy and causing exacerbation of symptoms.

LOAD MANAGEMENT 

A reduction in activities which apply stretching forces to the shoulder joint is beneficial in providing a window of opportunity for tissues to recover and desensitise.

SHOULDER JOINT TAPING

Taping may be utilised to provide short term pain relief during aggravating activities. 

IMMOBILISATION IN SLING

Traditionally, recommended that following a shoulder dislocation, period of 4-6 weeks of immobilisation in a sling. This is to allow damaged tissue, such as ligaments, muscle, bone, to heal and recover. 

A period of immobilisation will also prevent the likelihood of subsequent dislocations in the short term.

SURGICAL REFERRAL 

Pending the severity of damaged structures at the shoulder joint, immediate orthopaedic referral may be recommended. Surgical intervention may look to improve shoulder stability and function, with the goal of preventing further dislocations.

LONG TERM

RESISTANCE TRAINING

A specific and tailored strengthening and conditioning program should be conducted to improve long term outcomes and minimise risk of re-injury. 

MOBILITY EXERCISES 

It is important to consider mobility exercises for long term management of shoulder joint to maintain optimal shoulder joint mechanics, including pectoralis major, pectoralis minor, latissimus dorsi and upper thoracic. 

ONGOING TRAINING LOAD MANAGEMENT 

Training volume should be monitored and tailored for individuals to mitigate risk of re-injury or ongoing symptom exacerbation due to overload. 

SURGICAL REFERRAL 

If recurrent shoulder instability is present and multiple re-dislocations occur, it is essential to seek orthopaedic opinion. Surgical intervention may be required if conservative management fails to improve shoulder stability and function.