|
Dislocated
shoulder rehabilitation
Alternative exercises
How long will the effects of the injury last?
When can I return to my sport or activity?
Read
more about dislocated shoulders
As an athlete, your
number one concern is getting back to full strength as soon as possible
so that you can return to training and competition. That is why appropriate
rehabilitation is extremely important. Rehabilitation for a dislocated
shoulder often includes the following:
- reduce activity
during the acute phase
- ice injury multiple
times per day
- compression of
the injured shoulder with a secure wrap or ACE bandage
- elevation of the
injured shoulder above heart level
- use anti-inflammatory
medications such as ibuprofen to reduce inflammation and speed up recovery
The major objectives
of rehabilitation from a dislocated shoulder are to increase flexibility,
establish pain-free range of motion, and strengthen the muscles of the
upper back, front chest, and upper arm. In severe cases, you should avoid
activity that causes shoulder pain altogether. In these cases, you can
still maintain cardiovascular fitness by cycling,
unless otherwise prescribed by your doctor.
Rehabilitative exercises
should be performed on both sides of the body to maintain symmetry in
the strength and range of motion of the back, chest, and upper arms. In
many individuals, the tendency to experience shoulder dislocation is present
on both sides, so doing these exercises to increase the pain-free range
of motion and improve strength of both shoulders may help preventive injury
to either shoulder.
Rehabilitation exercises
often prescribed by your doctor may include:
- Shrugs
Stand with hands at sides with no weight in either hand. Raise shoulders
to the point of pain and hold for five seconds. Relax for five seconds.
Perform this sequence 10 times, 3 times daily. As pain permits, hold
dumbbells of equal weight in each hand while performing this exercise.
Add weight by using hand-held dumbbells as pain permits.
- Bicep curls
Stand with arms fully extended at sides while grasping 2- to 5-pound
weights in each hand, held palm forward. Flex the arms at the elbow
to approximately 100 degrees, or to the point of pain, whichever comes
first. Hold this position for 5 to 10 seconds. Return to the start position.
Rest for 5 seconds. Repeat this exercise 10 times. You can increase
the weight as pain allows and strength develops.
- Triceps curls
Stand with elbows directed upward over the shoulders and with arms relaxed.
Extend arms at the elbow so that the hands proceed upward to the point
of pain. Hold this position for five seconds. Return to the starting
position and relax for five seconds. Perform this sequence 10 times,
3 times daily. As pain permits, add weight by using hand-held dumbbells.
- Chest raises
Lie on belly with hands extended along sides of the body. Raise the
upper chest from the floor to the point of pain and hold this position
for 5 seconds. Return to the start position and relax for 10 seconds.
Repeat this sequence 10 times, 3 times daily.
- Saws
Reach out and place the unaffected side hand on a corner of a table.
Bend at the waist. Flex the injured side arm at the elbow and pull the
injured side arm backward and upward as if sawing wood. Slowly bring
the shoulder blades as close together as pain will permit. Slowly bring
the injured side arm down to its beginning position. Repeat this sequence
10 times, at least three times daily.
- Pendulum swings
Stand with the hand of the unaffected arm resting on the corner of a
table and supporting some of the body weight. Slightly bend the knee
on the unaffected side and extend the other leg sideways. Allow the
injured arm to hang loosely over the unaffected side foot. By shifting
the body weight, cause the relaxed injured arm to swing in circles to
the fullest extent possible as limited by pain. Perform 25 swings in
a clockwise direction. Pause. Perform 25 swings of the injured arm in
a counterclockwise direction. Repeat this sequence at least three times
daily.
- Shoulder rotation
Stand in a doorway with affected side arm bent at the elbow and the
palm of the hand against the doorframe. Turn the body away from the
injured side hand until a stretching sensation is experience in the
injured shoulder. Hold this position for 10 seconds. Return to the starting
position. Relax for 10 seconds. Repeat this sequence 10 times at least
three times a day.
- Shoulder Flexion
Stand erect close to a wall. With the palm of the injured side arm turned
so as to face you, slowly slide the forearm and then the upper arm up
the wall by moving closer to the wall. Slide the arm upward to the point
of initial significant pain. Hold this position for 10 seconds. Return
to the starting position and relax for 10 seconds. Repeat this sequence
10 times, at least three times daily.
- Towel stretch
Roll a towel lengthwise. While standing erect, dangle the rolled towel
down the back, holding it with the unaffected side hand. Reach behind
the back with the hand of the injured side and grasp the rolled towel.
Gently pull upward on the towel, raising the injured side arm until
first significant pain in the injured shoulder appears. Hold this position
for 10 seconds. Relax the arms while maintaining the grasp on the rolled
towel for ten seconds. Repeat this sequence 10 times at least three
times daily.
- Flexed elbow pull
Bend and raise the injured side elbow to shoulder height. Grasp the
injured side elbow with the uninjured side hand. Gently pull the injured
side elbow toward the opposite shoulder until limited by first significant
pain. Hold this position for 10 seconds. Relax for 10 seconds. Repeat
this sequence 10 times at least three times daily.
Several other exercises
might aid in rehabilitation of shoulder dislocation, and your doctor may
prescribe them in addition to or instead of those above. Substitution
or replacement of the above exercises are dictated by the exact nature
of the shoulder dislocation, whether it is a forward (anterior), rearward
(posterior) dislocation, or a downward (inferior) dislocation whether
it is a first time incident, and upon how the injury is responding to
treatment.
Depending on the severity
of the injury, some of the above exercises, and perhaps others of similar
nature intended to increase the range of motion of the injured shoulder,
may be prescribed to be done in water or a warm whirlpool apparatus. Water
relieves the arm of some of its weight, thus allowing a greater pain-free
range of motion, while warm water and a water massaging effect may also
be effective.
Alternative exercises
During the period when normal training should be avoided, alternative
exercises may be used. These activities should not require any actions
that create or intensify pain at the site of injury. They include:
How long will the
effects of the injury last?
Ligaments and tendons are the structures likely to be injured in most
shoulder dislocations, and often these tissues may take longer to completely
heal.
You can probably expect
to experience pain upon certain movements of the arm, swelling, and discoloration
for six weeks. But, it's not unusual for symptoms of the dislocation,
particularly pain upon forceful movements of the arm, to last as long
as 12 weeks. To some extent, the time to fully recover is influenced by
your dedication to your rehabilitation program.
When can I return
to my sport or activity?
Return to full participation should be avoided until you are symptom free
and can perform all skills and other requirements of your sport without
pain. To return earlier is to invite further injury to the shoulder, making
subsequent dislocations more likely. This is especially true when the
sport involves heavy contact, such as in football
or rugby.
Generally, the athlete
who wishes to return to a contact sport should expect to be out of action
for 6 to 12 weeks. Again, the time to return to full activity depends
on the dedication toward your rehabilitation program.
Remember: the goal
of rehabilitation is to return you to your sport or activity as soon as
is safely possible. If you return too soon you may worsen your injury,
which could lead to permanent damage. Everyone recovers from injury at
a different rate. Return to your activity is determined by how soon your
dislocated shoulder recovers, not by how many days or weeks it has been
since your injury occurred.
|
