Best 5 Exercises after a Shoulder Dislocation (Mobility Phase)
The shoulder is known as a ball and socket joint, making it one of the most mobile joints in the body. This is an advantage as it means we can engage in dynamic exercises and activities. However, it also means it is one of the joints most susceptible to dislocation. Shoulder dislocation can occur anterior (forwards), Posterior (backwards) and downwards. This is common in the active population between the ages 18–30 involved in contact sports such as rugby. Males experience dislocation more than females and there is a higher risk of reoccurring dislocation after the first experience. This is likely to be due to the higher number of men that play contact sports.
Depending on the severity of the dislocation, most dislocations will require a close reduction maneuver. This is when the arm bone is moved in a specific way so that it relocates into the socket. In complex cases an operation may be required, mostly this is done by keyhole surgery. This surgery aims to improve stability of the shoulder if there has been damage to the surrounding soft tissue such as ligaments, cartilage, and tendons.
There are two main types of shoulder dislocations: anterior and posterior.
Anterior shoulder dislocation: This is the most common type of shoulder dislocation, accounting for around 95% of all cases. It occurs when the humerus is forced out of the front of the shoulder joint, usually due to a fall on an outstretched arm or a direct blow to the shoulder.
Posterior shoulder dislocation: This is a less common type of shoulder dislocation, occurring in about 5% of cases. It happens when the humerus is pushed out of the back of the shoulder joint, usually due to a violent muscle contraction or a blow to the front of the shoulder. Posterior shoulder dislocations are often missed or misdiagnosed as a rotator cuff injury.
Once the shoulder has been relocated into the socket it is important to start the rehabilitation process. The shoulder may require some support and you may be put into a sling initially for comfort. This should not last longer than 2 weeks if there is no further damage. Initially you want to rest and let the shoulder inflammation and swelling reduce, but then quickly start moving to the mobility phase which involves encouraging gentle range of movement exercises. Strengthening the shoulder and improving mobility through exercise is required to improve your function and to reduce the chances of reoccurrence. Typically, your shoulder will be painful/ uncomfortable for the first 2-6 weeks. It is recommended to control your pain/discomfort with a combination of pain relief (paracetamol or ibuprofen, ice packs, avoid aggravation) and gentle movements.
If you have dislocated your shoulder through trauma, you need to go to A&E. Do not attend your GP surgery or physio clinic at this stage. Once the shoulder has been relocated, then please visit us in clinic. At Surrey Physio we will carefully examine you to understand what rehabilitation path would be best for you. We work with you to suite your lifestyle and achieve your goals. As the author of this article, I have successfully re-located one dislocated shoulder on the side of a rugby pitch. The shoulder had dislocated anteriorly and the chap knew his shoulder had been dislocated. He asked me to relocate it, at which point I said no, you need to go to hospital. He said “I’m a police officer, and I really just need you to put it back in”. I turned his arm and CLONK (imagine a loud crack sound) – the shoulder went back in, much to his relief. I have also unsuccessfully attempted two other relocations, both were just too stiff and I could not get them back in.
We have listed 5 exercises using our Rehab My Patient software to improve range of movement in your shoulder.
Seated Butterfly Table Shoulder Slide Flexion
Place your hands on a towel on a table, with your thumbs crossed with the affected side on top. Slide the towel away from your body and return to the start position. This exercise improves flexion in your shoulder.
Try 12 reps with 3 sets
Sit next to a table and rest your forearm on the table. Slide your arm away from you, as you lean in towards the table. Keep your arm in contact with the table. Go as far as feels comfortable. This is a mobilisation exercise for the shoulder.
Try 12 reps with 3 sets
Isometric shoulder abduction wall
Stand with your side to a wall. Push your arm away from your body into the wall. This will cause a contraction of the shoulder muscles. Hold the contraction, and relax. Repeat as required.
Hold for 10 sec and repeat 10 times
Isometric shoulder flexion wall
Stand facing a wall. Decide If you wish to use a bent arm, or a straight arm. It does not really matter which you choose. Push your arm in front of you, into the wall. This will cause a contraction of the shoulder muscles. Hold the contraction, and relax. Repeat as required.
Hold for 10 sec and repeat 10 times
Step Back External Rotation Through Range
Attach an exercise band to a door handle or stable object in front of you, and hold one end of the band in each hand. Start with your thumbs down. Step back and turn your arms outward so your thumbs are facing up, 30 degrees from your body. Repeat at 45 degrees, and then 90 degrees as you pull back both ends of the exercise band.
Try 12 reps with 3 sets
Shoulder dislocations are fairly big injuries and can become recurrent. Rehabilitation is important to improve your pain and mobility, and with any luck, reduce the likely chances of it happening again. You can find strengthening exercises following a shoulder dislocation here.
(Therapists: if you are reading this page, these videos are provided by Rehab My Patient – the best exercise prescription software for therapists to prescribe exercises www.rehabmypatient.com. Free trial available on their website.
Patients: If you are a patient needing advice or a course of treatment, call Surrey Physio to book a telephone/video consultation with one of our expert physios or osteopaths, or book in face-to-face for an appointment. You can call us on 0208 685 6930 or book online by clicking the link at the top of the page).