The term dislocation can be scary, and when it happens, it is even scarier. It is not just the pain that can make it scary; it is the feelings and thoughts about what to do next. The good news is that dislocations are more common than you may think, and we have an excellent handle on helping individuals return to their respective activities.

Roughly 95% of first-time dislocations are caused by a traumatic event and can account for up to 50% of all joint dislocations presenting to an emergency department.1 After a first-time dislocation is reduced by a physician, there is typically a period of immobilization followed by a course of physical therapy management.1,2,3 Treatment strategies will differ depending on if the individual has dislocated for the first time or suffers from chronic dislocations.

During a traumatic dislocation, the labrum, a ring of cartilage that helps increase stability, can become disrupted. Although damage to the labrum is possible, a person who experiences a dislocation for the first time is typically recommended to complete a course of Physical Therapy treatment. The good news is damage to the labrum does not necessarily lead to persistent pain; the shoulder can often become asymptomatic, meaning no signs or symptoms are associated with the labral injury.4 Depending on age and activity level, some individuals are at a higher risk of recurring dislocations.1,2,3 Rehabilitation is the first line of defense to minimize the probability of another dislocation. If the shoulder continues to dislocate, a stabilization surgery may be necessary and would require a consult with an orthopedic surgeon. Multiple dislocations can potentially increase the trauma to both the labrum and the shoulder joint.

Physical Therapy consists of regaining range of motion and improving tolerance into various positions that are uncomfortable to the individual. Rehabilitation will also include a variety of strength and conditioning exercises to improve strength and stability within the shoulder as well as guidance on returning the individual to their meaningful activities. If you are wondering if Physical Therapy is what you need or you have any questions, Nevada Physical Therapy offers FREE phone consults, click this link and one of our licensed physical therapist will contact you.

Written By: Dakota Ezell, PT, DPT

References:

1. Avila Lafuente J, Moros Marco S, García Pequerul J. Controversies in the Management of the First Time Shoulder Dislocation. Open Orthop J. 2017;11(Suppl-6, M17):1001-1010. doi:10.2174/1874325001711011001.
2. Robinson CM, Dobson RJ. Anterior instability of the shoulder after trauma. J Bone Joint Surg Br 2004; 86(4):469-79.
3. Te Slaa R, Brand R, Marti R. A prospective arthroscopic study of acute first-time anterior shoulder dislocation in the young: a five-year follow-up study. J Shoulder Elbow Surg. 2003;12(6):529-534.
4. Miniaci A, Mascia A, Salonen D, Becker E. Magnetic Resonance Imaging of the Shoulder in Asymptomatic Professional Baseball Pitchers. Am J Sports Med. 2002;30(1):66-73. doi:10.1177/03635465020300012501.