Injuries and Conditions: Shoulder Dislocations : Shoulder Dislocations :
Following the repositioning or reduction of the shoulder, the patient will be required to wear a speciliazed sling known as a shoulder immobilizer. The immobilizer prevents movement of the shoulder and allows the injured muscles, tendons, ligaments and joint capsule to heal.
With early reduction, immobilization and progressive rehabilitation, the expected recovery time is 10-16 weeks.
Physical therapy that focuses on strengthening the muscles that surround and stabilize the shoulder can significantly reduce the risk for re-injury.
Initially, activities which involve overhead motion should be avoided. Only when the shoulder has had sufficient time to heal and rehabilitate should this type of activity be resumed.
When the shoulder becomes dislocated, muscles, ligaments, tendons and the capsule itself can be involved in the injury. The tissue damage resulting from a dislocation may result in an increased risk for re-injury. The risk for recurrence and chronic instability are much greater in a younger, active individual and decreases with age.
Surgery may be required to repair tears in or to stabilize the joint capsule. Early surgical intervention is suggested for those who participate in overhead sports such as tennis, swimming, or baseball, and/or in those patients who eventually continue to experience symptoms of instability or dislocations. Approximately 50% of the patients diagnosed with a shoulder dislocation or subluxation will require surgery.
Patients are given a complete physical examination that provides an assessment of the individuals overall health.
Range of motion measurements are taken for each shoulder.
Diagnostic imaging studies may be performed to determine the extent of the injury to the joint capsule and to evaluate any underlying conditions.
Immediately after surgery, as anesthesia wears off, patients will usually feel tired and slightly disoriented, though the after-effects of anesthesia can vary greatly from patient to patient.
Post-operative pain will be present and may require over-the-counter or prescription medication to control the pain.
Passive range of motion exercises are begun on the first post-operative day to maintain shoulder flexibility.
Postoperative instructions:
Activity
Follow general post operative guidelines provided by your physician.
Be wary of any signs of infection, including swelling and redness.
No driving until instructed by your physician
Do not engage in activities that increase pain or swelling.
Maintain your arm in a sling at all times until instructed otherwise by your physician.
Ice Therapy
Begin ice therapy immediately after surgery.
Manual icing should be performed every two hours for twenty minutes until your swelling is controlled.
A critical part of a successful recovery from a shoulder dislocation or subluxation involves the active participation in a rehabilitation program. To reduce the risk for a second dislocation, strengthening the muscles that hold the head of the humerus in contact with the glenoid (shoulder socket) is of great importance. These muscles are called the rotator cuff muscles. They are strengthened by working against progressive resistance. It is important that the shoulder have both strength and functional range of internal and external rotation. The following rehabilitation program is presented as information only. Your physician and physical therapist will customize a rehabilitation program suited to your injury-specific needs.
90% of individuals under the age of 25 will sustain additional dislocations or subluxations. As you age, your risk for a second dislocation decreases.
A patient's goals and lifestyle may need to be altered, with normal activity levels being modified.
A complete recovery is dependent on the severity of the injury, the health and habits of the patient, and the underlying shoulder disorders or conditions present at the time of the shoulder dislocation.
Maintaining an active exercise and shoulder rehabilitation program is the best recommendation for recovery and prevention.
Risks during and after surgery include problems that may develop in relation to bleeding, infection, and/or anesthesia.
Injury to blood vessels and nerves within the shoulder region.
The possibility of experiencing unforeseen complications
The development of a stiff shoulder (frozen shoulder) following surgery.
Recurrent dislocation of the shoulder in the future.
Many shoulder reconstructions for shoulder instability can be performed arthroscopically, utilizing minimal incisions, as an ambulatory precedure. This may require the use of suture anchors to repair and tighten damaged tissue, as well as a recent surgical procedure called thermal capsulorrhaphy which by using heat selectively shrinks capsular tissue that may have become stretched out. Open surgical reconstruction or repair may be required in certain circumstances. Your surgeon will discuss the various options with you.
Following the repositioning or reduction of the shoulder, the patient will be required to wear either a simple sling or a specialized sling known as a shoulder immobilizer. The immobilizer prevents movement of the shoulder and allows the injured muscles, tendons, ligaments, and joint capsule to heal.
With early reduction, immobilization and progressive rehabilitation, the expected recovery time is 10-16 weeks.
Physical therapy that focuses on strengthening the muscles that surround and stabilize the shoulder can significantly reduce the risk for re-injury.
Activities, which involve overhead motion, should initially be avoided. Only when the shoulder has had sufficient time to heal and to rehabilitate should this type of activity be resumed.
A critical part of a successful recovery from a shoulder dislocation or subluxation involves the active participation in a rehabilitation program. To reduce the risk for a second dislocation, strengthening the muscles that hold the head of the humerus in contact with the glenoid (shoulder socket) is of great importance. These muscles are called the rotator cuff muscles. They are strengthened by working against progressive resistance. It is important that the shoulder have both strength and functional range of internal and external rotation. Your physician and physical therapist will customize a rehabilitation program suited to your injury-specific needs.
NSAIDs NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) are a group of drugs used to control pain. This category of medications includes both prescription and common over-the-counter painkillers such as ibuprofen. NSAIDs are effective for many types of pain that can occur because of inflammation of muscles, joints and bones. The drugs work quickly and people often notice some benefit within a few hours of taking the tablet. However, the complete effectiveness of the drug may not be realized for up to four weeks. For each individual, some varieties of NSAIDs are more effective than others. Often, patients will find that one or two varieties are helpful whereas others may not be as effective in controlling symptoms. It is usually necessary to try several brands and continue with the one that is most suitable. NSAIDs can be used to treat:
Pain resulting from inflammation or swelling.
Pain after injury.
Joint pain and arthritis.
| Hot/Cold Pack The use of hot and cold packs to relieve pain and inflammation is a common method of treatment for many conditions. When the soft tissue groups become strained or irritated the rotating application of hot and cold can be beneficial.
Cold therapy numbs the nerves to reduce pain and combats swelling by constricting blood vessels and by slowing blood flow to the site of injury. The application of heat to an injury after a few days of cold therapy and after swelling and redness has been reduced promotes the healing process.
Heat therapy speeds up healing by increasing the flow of blood to the site of injury. Heat will also restore flexibility, relieve muscle cramping, and arthritic symptoms.
|
90% of individuals under the age of 25 will sustain additional dislocations or subluxations. As you age, your risk for a second dislocation decreases in relation to your change in activities.
Patient's goals and lifestyle may need to be altered, with normal activity levels being modified.
A complete recovery is dependent on the severity of the injury, the health and habits of the patient, and any underlying shoulder disorders or conditions present at the time of the dislocation.
Maintaining an active exercise program is the best recommendation for recovery and prevention.
Improper lifting of heavy objects following injury can result in re-injury.
The participation in sports where repetitive overhead motion may risk re-injury.
Re-injury due to continued exposure to activities that increase the risk.
Prolonged disability, which is rare, yet may result from repeated injury.
Recurrent inflammation at the point where the muscle attaches to bone.
Every patient and injury is different due to a variety of factors. Your physician will discuss with you various options available for management of your specific injury.
| Metal, plastic, or absorbable suture anchors are usually required to surgically repair/reconstruct an unstable shoulder.
Not usually applicable.