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Injury of the week - Shoulder Dislocation

Shoulder Dislocation 1

A dislocated shoulder occurs when the ball of the shoulder joint pops out of its socket or cup (see above image-right side). The most common mechanism is for the shoulder to dislocate anteriorly, or forward. This can happen as a result of a heavy impact/tackle, falling with an outstretched arm, or getting caught between another player while trying to make a tackle. In order for the head of the humerus to dislocate, tissue damage tends to occur. There are many structures within the shoulder joint that can be affected which include; ligaments, labrum, tendon, and bone. The stretching and/or tearing of these structures can become really problematic when it comes to rehabilitation as the risk or re-dislocation is high because the passive stability of the joint has been compromised.


Assessment of initial injury severity is extremely important and there are specific tests that both physiotherapists and medical practitioners can perform to gauge the extent of the damage.  These tests help guide decision making around rehabilitation and whether not orthopaedic specialisation is required. For sports people who have an unstable shoulder, it is generally seen that surgical intervention is the treatment of choice, especially in contact sports such as rugby. Post surgical rehabilitation tends to last between 3-6 months, however this can vary depending on the athlete, the specific sport, and the technique used in surgery. Either way, surgery is a good option to recreate passive stability that was lost as a result of the dislocation injury.  


In other cases, if the tissue damage is minimal or the integrity of the joint has not been compromised, the shoulder will be given 4-8 weeks to allow the tissues, ligament and joint capsule time to heal and stabilise conservatively. A number of weeks will be spent with the team physio's, working really hard at strengthening the muscles around the shoulder. When the athlete returns to play it is likely that the shoulder will be taped to provide another layer of control. Although all rehabilitation tries very hard to mimic game like situations, it is difficult to truly replicate what the shoulder will experience when in full game mode. Thus, the taping can be effective to provide the last bit of support an athlete may need.

Next session we will cover some exercises that may be included in the rehabilitation process.

Mike Killip
Recover Sports Medicine

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