Shoulder Dislocation

Pathophysiology

Dislocations can be after an injury (e.g rugby tackle or car accident and is usually the first incident) or without trauma (minimal force involved e.g reaching or turning in bed). The ball and socket joint of the shoulder is made up of the upper arm bone (Humerus) and the socket (Glenoid), this joint is supported by many ligaments as well as surrounding muscles and soft tissue. The most common direction of dislocation is forwards (anterior) but can also be backwards (posterior) or inferior (downward).

Symptoms

  • After Injury - may be visible deformity, swelling and bruising
  • Without Injury- general ache, usually relocates by itself or with minimal help, often hypermobile

Management

  • Activity modification
  • Ice or heat
  • Pain relief
  • Physiotherapy

Investigations

  • With Injury - X-ray,  usually needs relocating in A&E 
  • Without Injury - normally does not require investigations but physiotherapy can help improve stability and muscular control

Exercises to try:

Isometric Abduction

Isometric Abduction

Standing next to a wall or door with your arm straight

Gently push into the wall as if trying to lift your arm sideways away from your body

Hold for 30-45 seconds then rest and repeat

Wall Press Up

Wall Press

Standing with your hands on a wall or door, shoulder width apart

Step back with both feet 

Slowly bend both elbows to bring your chest towards the wall

Push back up to the starting position

Cat and Camel

Cat and Camel

Kneeling on all fours, hands under shoulders and knees hip width apart

Arch through your back, looking underneath you

Then tilt your pelvis and dip your back down whilst looking forwards

Repeat slowly, keeping your elbows straight

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