Shoulder dislocation is a painful situation, but it is not always easy to be perceived by the general population. Some of the most common causes are playing a sport like swimming, basketball or volleyball, having an automobile accident or lifting a heavy object incorrectly in the gym, for example.
When the arm bone, which is the humerus, returns alone to the shoulder joint, which is the glenohumeral, we call this fact subluxation, which can cause only pain in that place, with no need to immobilize, or any other treatment. But if this subluxation happens with any frequency, you must strengthen the muscles of that region to prevent it from happening again.
Sometimes the shoulder dislocation can also cause some injury to the rotator cuff tendons, requiring physiotherapy to recover. It is possible to know if these tendons have been affected if pain persists even after the shoulder movement has completely recovered.
Signs and symptoms of shoulder dislocation
The signs and symptoms of a shoulder dislocation are:
- Severe pain in the shoulder, which can radiate to the arm and affect the neck, One shoulder may be different from the other, higher or lower; Inability to perform movements with the affected arm.
Usually the person is holding the shoulder with the opposite hand because he knows that the shoulder has moved but the accurate diagnosis must be made by a specialist. Sometimes it may be necessary to perform an X-ray examination to better assess the injury and identify whether there is any major damage, such as a bone fragment within the affected joint. The doctor may also order an MRI to evaluate tissues such as the joint capsule itself, tendons and ligaments.
Here's what to do when a shoulder dislocation occurs.
How to treat
The most appropriate treatment for shoulder dislocation should be indicated by the orthopedic doctor after observing the person's age, joint position and health status. To relieve pain the doctor may prescribe an analgesic or anti-inflammatory.
The doctor can put the joint back in place and then bandage the region by placing the arm to the chest, to recover the tissues involved. Immobilization can be maintained for 3 weeks depending on the person's age, health style and general health.
After the removal of the immobilization, it may be necessary to recover the movements through stretches performed, respecting the pain limit. In some cases, when the limitation is large, physical therapy may be necessary to strengthen the muscles and prevent the episode from happening again.
Surgery is indicated for young people or athletes, especially when there is a lesion on the glenohumeral lip, looseness of the joint capsule or on the shoulder tendons to repair these tissues and also to prevent future dislocations in people who have several episodes of dislocation or subluxation per year. The surgery is usually done through an arthroscopy because the recovery is faster but in any case it is necessary to undergo physiotherapy for a few months before fully recovering the integrity and dynamics of the shoulder.
For people who practice physical activity it is recommended not to train the injured arm and shoulder in the first month, performing only physical therapy exercises. Athletes usually return to competition after 5 or 6 months of dislocation.
It is indicated after immobilization or surgery to recover range of motion, muscle strength and stabilize the shoulder joint, preventing further dislocations. The physiotherapist should evaluate the person and indicate the most appropriate physical therapy treatment because it can vary from one person to another. Sessions usually begin 3 weeks after the injury and can last for months, especially if surgery is performed.
Physiotherapeutic treatment can be done using strategies for pain relief, increased range of motion, wound healing, muscle strengthening and stabilization of the shoulder joint. Some treatments that can be useful are muscle relaxation, myofascial release with hands, tennis ball, rigid foam roller or vacuum therapy. Stretching exercises for the arm muscles in all directions and also the trapezius in the neck region should gradually be inserted exercises with elastic tape known as theraband to increase muscle resistance little by little.
To stabilize the shoulder when there is no more pain and it is possible to perform the exercises with the elastic band without any pain or movement restriction, proprioception and Clinical Pilates exercises can be introduced.
