The shoulders are the most movable joints in the body and the most prone to dislocation. A dislocation occurs when two bones separate at a joint they meet. Shoulder dislocations are most common in physical contact sports, although they can also occur in daily accidents like falls. Children, adults, athletes, and nonathletes could all suffer from a shoulder dislocation. Dislocated shoulders usually require the aid of a healthcare professional to reposition the joint. After the joint has been realigned, a physiotherapist oversees shoulder therapy and assists the patient in avoiding re-injury.
If you have a dislocated shoulder in Las Vegas, NV, our professionals at Suarez Physical Therapy will help you get back on your feet. Following a period of limited flexibility or immobilization, physical therapy can enhance muscle rebuilding and the stability of the shoulder. Physical therapy aids in the stabilization of the injured shoulder and the prevention of subsequent injuries or dislocations. Based on the severity of your injury, daily habits, and physical objectives, we could devise a treatment plan that is right for you. Physiotherapy sessions for shoulder dislocation treatment often last 4 to 6 weeks, depending on your age, the nature of the injury, and your health.
What is Shoulder Dislocation?
The shoulder is made up of three bones, that is the scapula, the clavicle, and the humerus. Generally, stability is attained through dynamic and static restraints. The humerus head stays aligned in the glenoid fossa. This enables the surfaces of the joint to be concurrently aligned with one another. Furthermore, the glenoid arc contains the glenohumeral joint reaction force. However, in the case of a shoulder dislocation, the net glenohumeral joint response force is disrupted. This enables the humerus head to extend beyond the glenoid arc. Static restraints include finite joint volume, adhesion/cohesion, joint conformity, and ligamentous stability, which includes the labrum. The inferior glenohumeral ligament, well known as IGHL, is the main ligamentous restraint to the anterior glenohumeral translation, especially when your arm is abducted and rotated externally.
A dislocated shoulder could occur as a result of an injury, such as falling on your shoulder or an outstretched arm, straining the shoulders beyond their normal range of motion (that causes the upper arm bone to pop out of its socket). Several parts of the shoulders can be damaged during a dislocation, including the labrum (the cartilage ring surrounding the socket), the ligaments, the bones, and the tendons and muscles that surround the joint. The anterior inferior capsule and labrum could also detach due to this anterior translation. This is referred to as a Bankart lesion. The rotator cuff muscles make up the majority of the dynamic restraints, but they also comprise the biceps and the scapular stabilizer musculature.
If a physiotherapist is unable to properly reposition the dislocated humerus, surgery is required. Following that, you can use a physiotherapy rehabilitation program to help you restore mobility, shoulder joint awareness, strength, and sport-specific skills. Therapy would also assist to reduce inflammation and pain, allowing for quick recovery. A physical therapist is trained to address musculoskeletal issues such as dislocated shoulders. We at Suarez Physical Therapy have an orthopedics team that can treat joint issues safely before or after surgery.
Types of Shoulder Dislocations
A shoulder dislocation could occur in both the posterior and anterior. The most common cause is trauma to the shoulder as a result of a direct posterolateral impact. Patients would also show signs of instability in one direction, which could lead to a shoulder dislocation. In this instance, the muscles are either "unprepared" or "overwhelmed" by the force. The annual incidence rate of primary shoulder dislocation ranges from 15.3 to 56.3/per 100,000 people.
1. Anterior Shoulder Dislocation
The anterior shoulder dislocation is responsible for 97 percent of first-time or recurrent dislocations. It's the most common type of shoulder dislocation and it occurs when your arm is positioned to an excessive extent of abduction and/or external rotation. The glenohumeral joint complex acts as the principal restraint on anterior glenohumeral translation while in this position. The glenohumeral joints are particularly vulnerable to dislocation in the 90° external rotation and abduction positions respectively as a result of lacking dynamic stabilization and ligamentous support.
The subscapularis, anterior capsule, middle and superior glenohumeral ligaments, the long head of the biceps as well as the middle and superior glenohumeral ligaments could be deficient supporting structures in an anterior shoulder dislocation. When the anterior capsule thins, it can show up between the middle and superior glenohumeral ligaments. The head of the humeral is particularly prone to dislocation at this point due to its natural fragility.
When an anterior shoulder dislocation occurs as a result of a traumatic incident, the anteroinferior displaced head of the humeral extends and often tears. This results in a loss of the anterior ligamentous capsule integrity, often leading to a separation of the anteroinferior labrum as well as the presence of a Hill-Sachs lesion. Concurrent rotator cuff injuries can occur in severe circumstances.
2. Posterior Dislocation
Posterior shoulder dislocation is rare, accounting for only 3% of all shoulder dislocations. It's caused by an external impact on the frontal part of a person's shoulder. The humerus is subjected to an indirect force that combines adduction, internal rotation, and flexion. This is often a result of an individual falling on his or her outstretched hand (FOOSH injury), seizures, or a motor vehicle accident. Due to the general traumatic nature of the injury, posterior shoulder dislocations could result in the rotator cuff or labral disease.
Understanding the Elements of Physiotherapy for Shoulder Injury
The shoulder joint is one of the most intricate joints in the body, which makes it vulnerable to injury. A joint subluxation, for example, occurs when the humerus slips out of place and then pops back into place. Dislocation is another common injury that occurs when the ball joint slips out of the socket. Based on the nature of your injury, a physical therapist can realign the dislocated shoulder joint without requiring surgical intervention. Close reduction alleviates or relieves pain almost immediately, and the operation takes one hour or less.
If your shoulder dislocates and you suffer additional injuries such as a humerus fracture, soft tissue injury, or a rotator cuff tear, you'll almost certainly need surgery. Some injuries cause the shoulder to become unstable, making it hard for the humerus to stay firm in its socket. The damaged and strained ligaments can be repaired and tightened by surgery. Physical therapy, whether sought after or before surgery, will include the following elements:
A shoulder dislocation has the potential to affect your posture. A patient who has suffered an injury as a result of an impact force, for example, would notice that his or her shoulder appears to be awkwardly positioned. Once you've fully recovered, restoring appropriate alignment guarantees that your shoulder functions and moves as it should.
Management of Pain
A shoulder injury can be extremely painful. Although a procedure can relieve discomfort, it is also likely that you will have soreness and bruises. To manage pain and reduce inflammation, a physical therapist could use ice and heat therapy, as well as other non-medicinal therapies.
Exercise is an important part of physiotherapy following shoulder dislocation surgery. After surgery, your arm should stay put and in a sling, which can create muscle tightness as well as reduce your shoulder's mobility. As a result, physical therapy would include gentle stretches and passive motions in several directions. Furthermore, treatment will focus on restoring the strength of your wounded arms. Improved stability can be achieved by restoring muscular strength around the injured shoulder.
How a Physical Therapist Can Help With Shoulder Dislocation
Following the repositioning of the dislocated shoulder joint, your arm would be secured in a sling to shield you from further harm and to keep your shoulder more relaxed. Your physiotherapist can assess your rehabilitation needs by reviewing your injury and health history as well as undertaking a physical examination. Based on the findings of the evaluation and your objectives, your physiotherapist will assist you through a rehabilitation program to regain your strength, mobility, joint awareness, and sport-specific skills. Your psychotherapist will also teach you how to manage your pain and reduce inflammation. Your treatment plan may include the following activities:
Exercising Range of Motion
Swelling and soreness can limit your shoulder's range of motion. A physical therapist would show you how to execute effective and safe exercises to get your shoulder back to the full range of movement. Manual therapy, also referred to as hands-on, may be used by your physical therapist to assist in relieving shoulder pain.
Exercises to Build Strength
Poor muscular strength can make the shoulder joints unstable, leading to possible re-injury. Your physical therapist could assess which strengthening exercise is appropriate for your shoulder rehabilitation depending on the severity of your condition and the level you are on the road to recovery.
Muscle Retraining and Joint Awareness
Specialized exercises assist your shoulder's muscles to relearn how to deal with sudden stresses. Your physiotherapist will develop individualized workouts to assist you in returning to your normal activities.
Training For a Certain Activity or Sport
You would require further rehabilitation customized to the demand and nature of the activities placed on your shoulder, based on the demands of your profession or the kind of sport you participate in. A physical therapist could develop a regimen that takes into account all of these factors as well as your injury. For instance, if you're an overhead thrower, like a baseball player, a physical therapist would walk you through a baseball throwing progression practice and pay close attention to the throwing mechanics.
Frequently Asked Questions About Shoulder Dislocation
Below are some of the most frequently asked questions regarding shoulder dislocations.
What Type of Physical Therapist Do I Require?
All physiotherapists are educated and trained to treat individuals with dislocated shoulders. You would have to consider the following:
- A physical therapist who has experience working with clients who suffered from musculoskeletal issues. Several physical therapists focus their practice on orthopedics
- Physical therapists who have completed a fellowship or residency in orthopedics or sports physiotherapy and are board-certified. This kind of physical therapist possesses the experience, skills, and advanced knowledge that could be useful in treating your condition
When searching for a physiotherapist (or any other type of healthcare professional), keep the following in mind:
- Seek advice from friends, family, or other healthcare professionals
- Prepare to explain your symptoms and concerns in great detail during your initial session with the physiotherapist, as well as what makes them worse
- When making an appointment with a physical therapy clinic, inquire about the physiotherapists' experience with shoulder dislocation
What Are The Signs And Symptoms Of Shoulder Dislocation?
A dislocated shoulder could show the following symptoms:
- Suffering from severe shoulder pains
- Swelling and bruises in your upper arm or shoulder
- Feeling numb and/or weak in your neck, arm, fingers, or hand
- Having difficulty moving your arms
- Your arm appears to be misaligned
- Having muscle spasms in the shoulder
If you're experiencing any of these symptoms, seek medical help right away.
Who Is At Risk of a Shoulder Dislocation?
Shoulder dislocation can occur to anybody, although it's more often in young individuals, who are likely to participate in sports and other strenuous activities. The elderly, particularly women, are in greater danger as they're more likely to slip or fall.
How Is A Dislocated Shoulder Diagnosed?
A healthcare professional will collect your medical records and examine your shoulders to make the diagnosis. Your specialist would also request that you get an x-ray to aid in the diagnosis.
What Therapies Are Available For A Dislocated Shoulder?
A dislocated shoulder is usually treated in 3 phases:
- The first phase is known as closed reduction, whereby your doctor restores the ball of the upper arm in its socket. You could start by taking pain relievers and relaxing the muscles of the shoulder. The severe agony should fade away once the injured joint is restored to its place
- The next step is to hold your dislocated shoulder in place by putting on a sling or any other device. You'll be wearing it for a few days to a few weeks
- When the swelling and pain have reduced, the final stage is rehabilitation. You'll do exercises and workouts to increase your muscle strength and range of motion
If you harm the tissues or nerves surrounding the shoulder, or if you experience recurrent dislocations, you could require surgery. Your shoulder could become unstable as a result of a dislocation. When this occurs, it requires less force for the shoulder to be dislocated. This implies that it's more likely to happen again. Your physical therapist could advise you to continue practicing specific exercises to avoid further dislocation.
What Causes A Shoulder To Dislocate?
As stated earlier, the shoulders are the most mobile joints in the body. They're also the joints that get dislocated the most. The following are common causes of dislocation:
- Accidents, such as road accidents
- Electric shocks and seizures could cause contractions of the muscles that would pull the arms out of their place
- Sports-related injuries
- Falling or slipping on an outstretched arm or shoulder
Is It Possible to Prevent This Condition or Injury?
Shoulder dislocations are caused by how loose the shoulders are and they are more prone to occur during aggressive or sports activities. Your physiotherapist can counsel you on which positions are most likely to result in dislocations and how to limit your likelihood of dislocation. If you have any of the following symptoms, you should see a physical therapist:
- Have shoulder ache, especially when engaging in strenuous activities
- Have sensations that make you feel like your shoulder is either shifting, slipping, or moving
- You would notice a popping sound in the shoulder, which is followed by pain
If you've had a previous shoulder dislocation, you're more likely to re-injure your shoulder if it doesn't recover fully or if you don't regain your regular joint awareness or shoulder strength. According to studies, a substantial percentage of dislocated shoulders would dislocate once again. Physiotherapists play a crucial role in preventing recurring shoulder injuries.
You risk reinjury if you resume sports or any aggressive activities too soon after an injury. Your physiotherapist can evaluate whether you're ready to get back to your sports and activities by ensuring that your shoulders are strong and stable to get back to action. A physical therapist would suggest a shoulder brace to help you gradually and securely resume your regular activities.
Find a Physical Therapist Near Me
Surgery and physiotherapy are required as part of the treatment for severe shoulder dislocation. Physical therapists develop therapy programs that are crucial to your complete rehabilitation. The sessions are meant to help you regain your shoulder's normal functionality and range of motion, enabling you to go about your daily activities with ease and even participate in sports and recreational activities.
We at Suarez Physical Therapy specialize in delivering effective therapy for injuries that affect the functionality and mobility of various parts of the body. If you're suffering from a shoulder dislocation in Las Vegas, we can help you get back to living a healthy lifestyle. Contact us at 702-368-6778 to set up an appointment or a consultation.