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August 18, 2009

Shoulder Rehab Following Dislocation

My uncle dislocated his shoulder this past week. My Mom wanted me to find some internet resources for him so that he would know what to expect from his physical therapy. Here's what I found.

Here is a good overview about shoulder dislocations. According to this site, it is unlikely that my uncle will need surgery because of his age and it is also unlikely that he will dislocate your shoulder again, also because of his activity level.

I also found a site that talked about expected healing time for dislocated shoulder.

And finally, I found an outline for stages of shoulder rehabilitation:

Stage 1: Following Reduction
* Aim: Immobilize to prevent further damage and support joint, reduce pain and inflammation
* Duration: Day 0-7
* The *shoulder* should be immobilized in a sling for at least a week depending on the severity of any associated damage
* Perform wrist and hand exercises such as moving each finger through its range of motion and clenching the fist to prevent stiffness and keep the blood flowing to the area
* Continue icing the injury regularly to reduce pain and swelling.
* If prescribed, take anti-noninflammatories
* You can try taping the *shoulder* for extra support

Stage 2
* Aim: Start to mobilize the *shoulder*
* Duration: Week 2-4
* When pain allows start mobility exercises for the *shoulder *(bend over and swinging the arm like a pendulum)
* Avoid the combined movements of abduction (taking the arm out to the side) and external rotation (turning the shoulder outwards) as this is often the position the injury occurred.
* Only exercise if pain free
* Continue to wear a sling when not performing exercises if you feel it necessary
* Ice after exercise if swelling occurs

Stage 3
* Aim: Achieve full range of motion and begin strengthening
* Duration: Weeks 4-6
* Begin isometric (without movement) strengthening exercises providing there is no pain (pressing your arm against a door jamb in several directions)
* Begin to move the shoulder into abduction (straight out to the side) and external rotation if comfortable to do so, but do not perform strengthening exercises in this position.
* Continue with mobility exercises
* Try to achieve a full pain free range of movement
* Try to avoid wearing a sling

Stage 4
* Aim: Achieve strength equal to uninjured side and maintain mobility.
* Duration: Weeks 6-10
* Progress strengthening to resisted exercises if pain free (usually with therabands)
* Progress to perform external rotation strengthening in the abducted position if comfortable.
* Continue with mobility exercises to maintain full range of motion
* Introduce proprioception exercises

Stage 5
* Aim: Return to sport
* Duration: Weeks 10-16
* Increase resistance used for strengthening, progress to dumbbells and body weight exercises
* Start functional activities such as throwing (start underarm and progress) and catching
* Begin a gradual return to sport, starting with training drills, non-contact and slowly increase the demand on the shoulder

Posted by linda at August 18, 2009 7:00 AM

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