Physical Therapy after a Shoulder Dislocation

What It Takes to Get an Injured Joint Back to Normal

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The shoulder joint is a complicated structure and surprisingly prone to injury: For instance, the ball of the joint, which is located at the end of the upper arm bone (the humerus), can slip out of the socket—the cup-shaped structure at the end of the collarbone. Sometimes the joint will pop back together spontaneously; the injury is considered a subluxation of the joint. If the ball and socket stay separated, it's called a dislocation.

Most shoulder injuries of this type are caused by some sort of trauma: a forceful blow from beside or behind the shoulder while playing a sport, for example. Falling and landing on an outstretched hand also could cause the shoulder joint to separate. And people born with especially loose shoulder joints, a condition called shoulder multidirectional instability are prone to frequent subluxation.

Whatever the nature of the injury and whatever the cause, if you have a shoulder dislocation, it's likely you'll need physical therapy after your shoulder joint has been repositioned correctly and any secondary damage, such as a torn rotator cuff or fracture of the humerus has been treated.

Beginning PT After a Shoulder Injury

Chances are your arm will be in a sling for awhile after your shoulder is treated, especially if you had surgery. Even so, your doctor may send you to a physical therapist right away so you can start some preliminary exercises to prevent your shoulder from becoming frozen due to imobility.

He'll provide a prescription for the type of exercises you should do based on your injury and treatment that the physical therapist will then use to create a PT program for you.

At your first appointment, the therapist will ask you questions about your injury, your pain level, and your ability to move after surgery.

He'll take measurements of your range of motion and strength to create a baseline for comparison as you progress in your treatment.

Elements of Physical Therapy For a Shoulder Injury

In order to get your shoulder back to health, your physical therapy will need to focus on several factors.

Pain Relief. Shoulder injuries hurt; so do shoulders that have been operated on. Besides pain, you'll likely have swelling and bruising. Part of your PT may include icing and or heat to help ease pain and reduce inflammation. Some therapists use modalities like ultrasound and transcutaneous electrical nerve stimulation (TENS) for pain, but research studies have shown that these treatment methods aren't very effective, so many PTs no longer offer them.

Range of Motion. In order to loosen up muscle tightness in the shoulder that can limit how far you're able to move your arm, the therapist will likely do some passive motion work with you, in which he moves and gently stretches your arm in different directions. He also may teach you ways to do this kind of stretching yourself.

Strength. Restoring strength to the muscles that surround and support the shoulder joint is vital to giving it the stability it needs to function normally.

These are the rotator cuff muscles, the biceps and triceps, and the muscles that support the shoulder blade.

Occasionally, the muscles around your shoulder are not able to contract properly. Your physical therapist may choose to use an electrical stimulation device called neuromuscular electrical stimulation (NMES) to help your muscles regain the ability to contract.

Posture. Rounded shoulders and other improper postures can interfere with how well the shoulders work, so your therapist may have you work on improving your posture. The better aligned your skeleton is overall, the more easily you'll be able to move and function.

How Long Will Therapy Take?

While every injury is different and everyone heals at different rates, most people are back to normal after dislocating a shoulder in eight to 12 weeks. If the injury to your shoulder is severe or you required surgery, it will take longer. Either way, you can trust that your surgeon and physical therapist will work together to make sure the therapy you do is targeted to getting you back to normal as soon as possible.

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