Shoulder dislocation (fully out) or subluxation (partially out) can occur traumatically or without trauma (this is normally a sign of hypermobility syndrome). The usual movements involved in this injury are a combination of shoulder abduction (side elevation) and excessive external rotation (outer rotation of the humerus)
The shoulder joint is stabilised by the shoulder labrum and capsule (as well as the surrounding muscles). The labrum is a cartilage-like ring surrounding the glenoid and the capsule is a large ligament that connects the humerus to the glenoid. During a dislocation the labrum and/or ligaments stretch or tear. The shoulder may dislocate either out the front (anterior), out the back (posterior) or out the bottom (inferior – subluxatio erecta).
Patients with a dislocated shoulder usually experience sudden severe pain at the time of injury. The patient will often cradle the arm against their body. Pain is usually felt in the shoulder region, however can occasionally radiate down the arm.
Patients with this condition will often experience a sensation of the shoulder ‘popping out’ at the time of injury. Occasionally, patients may experience pins and needles or numbness in the shoulder, arm or hand.
Rehabilitation is crucial following shoulder dislocation. Many patients with a dislocated shoulder heal well with appropriate physiotherapy and return to normal function. However, some patients may experience long term effects such as an increased likelihood of future dislocation. Surgical repair may be needed depending on the amount of damage caused.
Treatment for Shoulder Dislocation / Subluxation
Physiotherapy treatment for patients with this condition is vital to hasten the healing process, ensure an optimal outcome and decrease the likelihood of injury recurrence. Treatment may comprise:
- Exercise programs to improve proprioception, and strength (rotator cuff and scapular rhythm)
- Deep tissue massage/myofascial release
- Joint mobilisation
- Joint manipulation
- Dry needling /acupuncture
- Biomechanical assessment
- Postural Correction
- Activity modification advice
- Ice or heat treatment