Aug
2022

Shoulder Dislocation

August 13th, 2022

Glenohumeral Joint

shoulder girdle (upper arm, shoulder blade or 'scapula', and collarbone), most mobile 'functional unit' in body, comprised of a number of articulations (joints): scapula-upper arm, scapula-rib cage, scapula-collarbone, sternum-collarbone, spine-ribs, and spinal articulations of neck and upper back
all articulations of shoulder functional unit must be able to move and do so in a coordinated manner to permit full, dynamic range of motion of arm
shallow glenohumeral (scapula-upper arm) socket permits significant mobility of arm at expense of joint stability
glenoid labrum, hard cartilaginous extension of shallow joint socket, deepens socket thereby augmenting joint stability

result of trauma, usually fall onto outstretched arm, +/- anatomical predisposition and/or repeated previous physical insults to shoulder
in most cases ball of shoulder shears forward tearing anterior (front) structures including capsule and ligaments and possibly damaging glenoid labrum

application of electrotherapeutic modalities to reduce inflammation and pain
joint range in middle aged patient facilitated and constantly monitored to prevent onset of 'frozen shoulder'
surgical repair: <3 weeks post-op joint relatively immobilized (wearing of sling with no arm activity above shoulder height or forced outward movement) to protect healing soft tissue and maturation of scar tissue; isometric strengthening exercises assigned; over next 3 weeks above-horizontal range of motion gradually reacquired and active isometric rotator cuff muscle strengthening exercises assigned (utilizing resistive tubing, pulleys, or free weights)
from six weeks post-injury: movement (including stretch), strengthening (including weight bearing and isotonic loading) conditioning, and functional retraining activities exercises progressed to promote full range of motion (including outward rotation) and functional performance ability

recurrent dislocations: surgical tightening of tissues at front of shoulder joint may be recommended
post-surgical rehabilitation similar to that following dislocation except that more aggressive strengthening can begin after immobilization period
joint may not recover all of its range after surgery

total post-surgical rehab process typically takes about three months
attendances at clinic scheduled less frequently as recovery progresses and emphasis shifts to self-management program -- home or gym exercise routine
return to activity: therapist will advise according to evaluation of physical demands of your particular work and/or sport

New designs of mountain biking body armor include straps that provide joint protection against dislocation