A shoulder dislocation occurs when the upper arm’s humeral head slides out of the shoulder socket. The concern can be addressed using surgical or nonsurgical treatments. Depending on the cause of the dislocation and the severity of a patient’s symptoms, surgery is recommended immediately or after attempting nonsurgical treatments like physical therapy. If you have undergone shoulder dislocation surgery in Las Vegas, NV, turn to Suarez Physical Therapy for reliable rehabilitation. Through physical therapy, you can improve shoulder stability and rebuild muscle following a period of immobilization or limited flexibility.
Physical therapy helps stabilize the treated shoulder and prevent further injury or future dislocations. We can create a suitable treatment plan for you based on the state of your injury, your physical goals, and your daily routines. Often, physical therapy sessions following shoulder dislocation therapy run for 4 to 6 weeks, and the recovery period will depend on your state of health, age, and type of injury.
Physical Therapy after Shoulder Dislocation Surgery Overview
The shoulder is among the most mobile joints in your body and has a wide range of motion. This also makes it more susceptible to dislocation (separation of two bones at a joint).
Physical therapy treatments after shoulder dislocation surgery can help to protect the realigned joint from future injury. Your therapist will help you perform a range of simple exercises designed to strengthen and stretch the muscles around the shoulder. The period of immobility between an injury, surgery, and your first physical therapy session can make the shoulder muscles weak and unable to bear the weight of your arm during movement.
Therefore, treatment focuses on developing stronger muscles, increasing flexibility, and restoring your natural range of motion. Physical therapy also helps in pain management and accelerates full recovery.
Shoulder Dislocation Defined
The shoulder has several bones, including the collar bone (clavicle), upper-arm bone (humerus), and the shoulder blade (scapula). The upper-arm bone has a rounded top that slides into the cup-shaped end of the shoulder blade. The shoulder joint functions like a bowl and socket to allow 180° flexion and abduction, 90° external rotation, and 360° circumduction, among other shoulder movements.
A dislocation occurs when the humerus slides out of the socket. This can happen because of a fall, overstretching your arm, or trauma that forces your shoulder to move beyond its usual range of motion. A dislocation can weaken the shoulder by causing damage to the bone, ligaments, tendons, muscles, and labrum.
Some of the common symptoms of shoulder dislocation include:
- Movement limitations
- An awkward alignment of the shoulder
If a physical therapist cannot safely move the dislocated humerus back into position, you first have to undergo surgery. After this, a physical therapy rehabilitation program can help you restore your shoulder's joint awareness, mobility, strength, and sport-specific skills. Therapy will also help to relieve inflammation and generally ease the pain for a quick recovery.
Physical therapists have the training and skills required to treat musculoskeletal problems, including dislocated shoulders. At Suarez Physical Therapy, we have a team that specializes in orthopedics and can provide safe treatment for joint concerns before or after surgery.
Understanding the Three Elements of Physical Therapy for Shoulder Injury
The shoulder joint has one of the most complicated structures that makes it prone to injury. For instance, the humerus can slide out of place and pop back together, causing a joint subluxation. Another common shoulder injury is dislocation which involves the ball joint sliding out of its socket.
Depending on the severity of an injury, a physical therapist can reposition a dislocated shoulder joint (closed reduction) without any need for surgical intervention. Close reduction reduces or alleviates the pain almost instantly, and the procedure takes an hour or less.
If an incident leaves your shoulder dislocated and causes secondary damage like humerus fracture, tearing of the rotator cuff, or soft tissue injury, you will likely require surgery. Some injuries destabilize the shoulder, making it impossible for the humerus to remain in its socket firmly. Surgery helps to repair and tighten the torn and stretched ligaments.
Whether you seek physical therapy before or after surgery, treatment will involve the following elements:
A shoulder injury causes devastating pain. An operation can make the pain subside, although you are also likely to experience soreness and bruising. A physical therapist can provide heat and ice therapy, among other non-medicinal treatments, to reduce inflammation and manage the pain.
Another critical element of physical therapy following shoulder dislocation surgery is exercise. Because your arm has to remain motionless and on a sling after an operation, this can cause muscle tightness and limit your shoulder’s range of motion. Therefore, physical therapy will involve doing passive motions and gentle stretches in multiple directions.
Moreover, treatment will also aim to restore your injured arms strength. Restoring muscle strength around the affected shoulder helps to improve stability. Muscle-strengthening exercises target the shoulder blade muscles, biceps, triceps, and rotator cuff muscles. Your therapist can also opt for neuromuscular electrical stimulation to help your shoulder muscles contract correctly.
Any physical therapy treatment will always involve the therapist guiding you through special exercises that improve how your shoulder responds to different demands. Your therapist will instruct you on positioning your arm and shoulder to prevent injury before you recover fully. These exercises also correct body mechanics to reduce the risk of future re-injury.
Shoulder dislocation can impact your posture. It is common for patients who suffer an injury following impact force, for instance, to notice that their shoulder looks awkwardly positioned. Restoring proper alignment ensures the shoulder moves and functions as intended once you recover fully.
When to Seek Physical Therapy After Shoulder Dislocation Surgery
The acute recovery period following surgery is challenging, and your surgeon is likely to prescribe opioid medication to help with pain management. Because of the highly addictive nature of opioids, it is recommended that you only take them for the shortest possible duration. Your doctor will recommend the use of NSAIDs (non-steroid anti-inflammatory drugs) once you complete your opioid prescriptions.
Other effective methods of pain management following shoulder dislocation surgery include:
- 10 to 15 minutes of cold therapy several times daily (also alleviates inflammation)
- Gentle exercises to improve blood circulation and flexibility
- Physical therapy aimed at fending off stiffness and improving the shoulder’s range of motion
Cold therapy can begin after you are discharged from the hospital. It is safe to engage in gentle exercises at home at least two weeks following surgery.
Here are other timelines you should know about:
When To Begin Physical Therapy
Physical therapy (PT) should begin 3 to 4 weeks after surgery. Shoulder or arm movement restrictions are often necessary to allow the affected sight to heal. PT treatment programs start with gentle motions that increase flexibility and then move to more extensive stretching to enhance your shoulder’s stability. Later in the treatment plan, you will engage in resistance exercises designed to increase joint and muscle strength.
Most patients, especially those whose duties do not involve any form of lifting, can resume work at least two weeks after surgery. You can engage in light-duty manual work about four weeks from surgery, as long as you go easy on the affected shoulder and arm.
Consistent physical therapy sessions for at least six weeks should effectively rehabilitate your arm. At this point, you can use it usually, although it makes sense to avoid forceful movements like pushing or lifting heavy objects. You can drive, prepare meals and handle other less strenuous jobs.
If you are a fan of sports, you must visit your physician after physical therapy treatments before you return to the field. Sports that require the intensive use of your arm, like volleyball, are highly advised against for several months following treatment. Sports like swimming and golf, on the other hand, could be approved right after your dislocated shoulder rehabilitation program.
Patients need to understand that a severely injured shoulder may take up to a year to recover fully. While therapy helps ease the pain, build strength and improve your range of motion, it is best to keep off activities that have a high likelihood of causing further injury.
What to Expect During Post Shoulder Dislocation Surgery Physical Therapy
Surgery can effectively repair and restore the structural integrity of a dislocated shoulder. The orthopedic surgeon will repair damaged tissue and generally stabilize the shoulder. The injured arm should remain on the sling for 4 to 6 weeks to recover properly.
It is essential to follow postoperative instructions to the latter because the healing site is susceptible to reinjury. For instance, the affected arm should remain on the sling for the recommended period, and you should also refrain from using your arm for the usual daily activities. Also, ensure proper positioning of the arm, do simple exercises and apply ice therapy as recommended to control pain and prevent stiffness or soreness.
Before you begin your physical therapy sessions, the specialist will consider your condition, the recommendations of your orthopedic surgeon, and your goals. While most patients regain full use of their arm after six weeks of physical therapy, remember that it will take longer to be clear to return to strenuous activities, heavy lifting, and intensive sports.
Here is what to expect during your physical therapy sessions following shoulder dislocation surgery:
4 To 6 Weeks Post-Surgery — Gentle Range-Of-Motion Exercises
The first phase of treatment will involve protecting the postoperative site as much as possible while ensuring proper healing. At this point, your shoulder will be at significant risk of re-injury, and you may still need help with daily chores like maintaining personal hygiene.
Gentle range of motion exercises can help reduce the pain and swelling. Your physical therapist will guide you through movements that only involve using your arm’s weight. Also, you can expect gentle massage sessions designed to ease the soreness and stiffness. Other techniques applied to alleviate the pain include cold compression and electrical nerve stimulation.
Generally, the exercises applied during this phase of treatment will aim at restoring your shoulder’s full range of motion.
These exercises may include:
- Pendulum exercise — Pendulum exercise involves allowing the affected arm to straighten and dangle freely before swinging it gently for a maximum of three minutes. The workout is easy on the shoulder and can be done each day severally, at least two weeks following shoulder dislocation surgery.
- Shoulder-forward elevation — The shoulder-forward elevation is an exercise that involves putting your hands together and cupping your fingers. You will then need to lift the arms above the head for a maximum of 20 seconds. It is necessary to keep your elbow as straight as you can before slowly lowering your arms. During the first therapy sessions, you simply need to raise your hands as high as you can. You can increase this height as you progressively recover.
- Shoulder extension — Shoulder extension is perhaps the most straightforward workout that most patients can do once they begin physical therapy. It involves leaning on a wall and stretching your hands out to the sides to touch the wall. You should maintain the position for at least 5 seconds before slowly lowering your arms.
- Supported shoulder rotation — Supported shoulder rotations can be done from a seated or standing position. You need to rotate your forearm (lower half of the arm) back, forth, and sideways.
- Walk-up exercise — The walk-up exercise involves using the fingers on the affected arm to crawl up a wall slowly. Again, you do not need to strain during your first therapy sessions, and it is perfectly okay to make your hand reach as high as you comfortably can. Hold the position for at least 10 seconds and slowly use your fingers to crawl down the wall.
It is crucial to only engage in the above rehabilitation activities under the supervision of a skilled physical therapist. Again, each patient is different, and the right set of exercises will highly depend on the severity of your injury and recovery pace.
6 To 8 Weeks Post-Surgery — Muscle Strengthening Exercises
At least one-month post-surgery, your physical therapist can begin working on restoring your shoulder’s range of movement. By the time you are six weeks following the operation, you can now reduce the number of hours your arm stays on the sling. This also means that you can safely begin muscle strengthening exercises.
Muscle-strengthening exercises help to reduce the risk of reinjury. Your shoulder joint will gain enhanced stability as your muscles strengthen. Your physical therapist will choose an ideal set of exercises to do depending on the severity of your injury.
2 To 3 Months Post-Surgery — Muscle Retraining and Joint Awareness
The third phase of physical therapy will involve activities designed to help your muscles relearn the correct response to different forces. Sessions will be instrumental in enabling you to resume regular activities within the least time possible. The goal of treatment is to make your injured shoulder have equal strength and joint awareness as the healthy shoulder.
Muscle retraining sessions involve a set of exercises that are slightly advanced in difficulty. These exercises help to strengthen the shoulder blade, trunk, and rotator cuff muscles. The stronger muscles will provide extra support and make your shoulder more stable.
At this point, you can return to regular activities and perhaps even engage in a gym-based program using machines like an exercycle and treadmill. While your arm may feel somewhat healed, your therapist will not recommend engaging in physically strenuous activities. Again, your shoulder is not fully healed, and you must protect it from the risk of reinjury.
At Least 4 Months Post-Surgery — Sport or Activity Specific Training
The last phase of treatment is crucial to help your shoulder muscles relearn how to perform specific work or sport-related activities safely. Sessions aim at enabling the affected arm to do higher-level activities safely. Depending on your goals, rehabilitation could involve lifting weights, throwing or catching a ball, shoveling, raking, and more.
It remains imperative to understand that even one shoulder injury dramatically increases your risk of reinjury. It is best to give your shoulder enough time to heal, regain normal functions and rebuild its strength. Fortunately, physical therapy helps minimize the chances of a shoulder problem recurring. Your therapist will run tests to determine whether your shoulder is strong enough for you to resume sport or highly strenuous activities safely.
Find a Physical Therapist Near Me
Severe shoulder dislocation requires both surgery and physical therapy as part of treatment. Physical therapists provide treatment plans that are integral to your full recovery. Sessions are designed to restore your shoulder's normal range of motion and functions, allowing you to comfortably perform everyday activities and even engage in recreational activities and sports. At Suarez Physical Therapy, we specialize in providing effective treatment for conditions that affect the mobility and functions of various body parts. If you have undergone shoulder dislocation surgery in Las Vegas, NV, turn to us for treatment aimed at ensuring you can get back to enjoying an active lifestyle. Call us today at 702-368-6778 to schedule a consultation or book an appointment.