Shoulder dislocation injuries can occur as a result of a wide variety of situations. Generally caused by a jarring motion when the shoulder is in a less-than-ideal position, shoulder dislocation often occurs due to collisions during contact sports, automobile accidents, or falls. People who are hyper-flexible can actually be more prone to dislocation, since the muscles and connective tissues are overly stretched. For some, even a sneeze can be enough to pull the shoulder out of its socket!
Typical Reasons for Dislocation
Not all joints are as prone to dislocation; the shoulder is, by nature, an unstable joint. The upper arm bone, or humerus, has a ball-shaped top that fits loosely into the shallow, socket-shaped area of the scapula. While there are plenty of muscles, ligaments, and other connective structures designed to hold the humerus in place, there’s also a lot of leeway to allow for range of motion. We appreciate that free range of motion when we perform everyday activities like reaching behind our backs to scratch an itch as well as when we do athletic activities such as spiking a volleyball or throwing a line drive. While such freedom of motion is certainly positive, it comes with a price tag: joint stability.
The typical shoulder dislocation occurs “anteriorly,” meaning that it’s caused by the head of the humerus bone coming forward, out of the joint. (Imagine a baseball pitcher and the direction in which a dislocation would likely occur.)
Ideal Responses to Dislocation
Those who have dislocated their shoulders can prevent future trauma by strengthening the muscles surrounding the joint. Care should be taken to patiently wait for a shoulder joint to heal in order to receive the “all clear” from your physician while avoiding extreme positions during early rehabilitation. At first, it’s best to stick to isometrics, which involve offering resistance without moving the shoulder itself. You can see an example in exercise #10 here.
While physical therapy and exercises are the ideal remedy for shoulder dislocation, orthopedic surgeons generally prescribe surgery for patients who dislocate their shoulders repeatedly, particularly within a short time span. Often, the reason rehab is unsuccessful is due to the tearing of the cartilaginous ring surrounding the socket. Referred to as the “labrum,” this structure provides stability to the joint, so a tear compromises that stability. Even when the muscles surrounding the shoulder are strengthened, active motions involving the shoulder can cause chronic pain without surgical repair.
Before surgery is considered, patients dealing with shoulder dislocation should pursue conservative management techniques such as strength training exercises, and any good orthopedic surgeon will insist on such an approach. Even with surgery, patience will be needed in order to achieve full restoration and full range of motion without pain.
PhysioDC of Washington, D.C.
Daniel Baumstark and his professional team of physical therapists operate a boutique physical therapy office in downtown Washington, D.C. From athletes to government officials, and from ballerinas to corporate executives, PhysioDC helps people recover, strengthen and return to healthy living. Visit their site at PhysioDC.com or call them at 202-223-8500.
Image credits: Katrina Elena Photography / Fotolia; Aykut Erdogdu / Fotolia
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