Shoulder instability following an injury
What is traumatic Shoulder Instability?
Traumatic shoulder instability can happen after a high force injury. It can result in dislocation or subluxation of the shoulder which can then lead to pain and discomfort. The joint can spontaneously relocate, but sometimes it needs to be put back into position. Anterior (forward) dislocations are the most common.
Males are over twice as likely to suffer a traumatic dislocation as females. The most common age range is between15 years and 30 years. However, this injury is also common in women over the age of 80 following a fall.
Immediately after injury the aim is to identify the dislocation and any associated injuries and to get the shoulder joint back into position without any further trauma. The Orthopaedic team may decide to let the injury heal by itself or surgery may be required.
Usually a sling would be advised to keep you comfortable in the early days. It should be removed from time to time as soon as is comfortable. The sling is usually not used for more than two weeks. It is important to keep the hand, wrist and elbow moving to prevent stiffness and practice gently moving the shoulder forwards and out to the side using the support of the other arm if this is helpful.
Applying ice, cooling spray or cold gel packs in the early stages can help control pain. Use ice or a bag of frozen veg wrapped in a cold, damp tea towel or cloth to help the cold conduct really well and help to minimise any risk of ‘cold burn’ to the skin that may occur.
Often common painkillers like Paracetamol and Ibuprofen may also help. It is advised you discuss the use of these with your GP or pharmacist.
Generally you can return to most activities as soon as you feel comfortable. For any heavier activities or posts like tennis or rugby then usually you should wait until after six weeks.
Rehabilitation is focused on regaining full movement of the shoulder initially before rebuilding the strength of the muscles around the shoulder girdle, particularly the rotator cuff muscles, the deltoid muscles and the scapula stabilisers.
Exercises to improve the movement of your shoulder are listed below. Perform these within a comfortable range and progress as able. You can use your unaffected arm to help support your affected arm if required.
Below are some early strengthening exercises:
When ready, progress to these dynamic strengthening exercises. You can make these more challenging by increasing the weight you use.
The exercises will help you get back to full activities. If you are planning on returning to sporting activities particularly those that involve overhead activities or contact then there is always a chance the shoulder may dislocate again. It is important to go back to some training sessions, practice the skills needed in a training environment before progressing to competition.
If you feel you need additional help you can refer yourself here.