What to do (on field) after an Acute Shoulder Dislocation?

Jul 2, 2025 | Health

By Dr. Chirag Arora

Shoulder Dislocation

WHAT TO DO (ON FIELD) AFTER AN ACUTE SHOULDER DISLOCATON?

Here’s a general roadmap for what to do after a shoulder dislocation. Keep in mind every case is unique—always follow the advice of the shoulder specialist/physician.

1. Seek Immediate Medical Evaluation

  • Reduction by a Professional
    A dislocated shoulder should only be put back in place (“reduced”) by a trained clinician. Attempting self-reduction can damage nerves, blood vessels, and the joint surfaces.
  •  Neurovascular Exam & Imaging
    After reduction, your doctor will check your pulses, sensation, and motor function in the arm, and will usually obtain X-rays (and sometimes MRI or CT) to confirm the joint is back in place and rule out associated fractures or soft-tissue injuries.

2. Acute Care (First 1–2 Weeks)

  • Instability assessment is done by your shoulder specialist/orthopedic surgeon
  • Immobilization (not usually required, unless very unstable : assessed by your shoulder specialist)
    You’ll typically wear a sling (sometimes with an abduction pillow) for 2 weeks, depending on your age, activity level, and whether it’s a first-time or recurrent dislocation.
  • Pain & Swelling Control
           o Ice the shoulder for 15–20 minutes every 2–3 hours.
           o Take NSAIDs (e.g., ibuprofen) or acetaminophen as directed for pain relief.
  • Gentle Pendulum Exercises
    Starting around day 3–5, you can do small “pendulum” swings: lean forward, let the arm hang, and gently circle it 10 times in each direction. This helps prevent stiffness.
  • In our practice, we always do a MRI assesment to ascertain the extent of damage and predict the chances of recurrence.

3. Early Rehabilitation (Weeks 2–6)

  • Passive & Assisted Range of Motion
    Under guidance, you’ll begin to gently move the shoulder within a pain-free range—often with the help of your opposite arm or a therapist.
  • Avoid Risky Positions
    Do not force external rotation or full overhead reaching until your surgeon/therapist gives the go-ahead.
  • Isometric “Pre-Strengthening”
    Begin light, static muscle contractions (pushing your hand gently against a wall) to maintain muscle activation without joint movement.

4. Progressive Strengthening and return to sports (Weeks 6–12)

  • Active Range of Motion (AROM)
    You’ll work on moving the shoulder through its full, pain-free range under your own muscle power.
  • Resisted Exercises
    Using light resistance bands or small weights, focus on the rotator cuff muscles (supraspinatus, infraspinatus, subscapularis) and the scapular stabilizers (serratus anterior, trapezius).
  • Proprioception & Neuromuscular Control
    Exercises like ball-throws against a wall, rhythmic stabilizations, and weight-bearing on the elbows can help retrain joint sense and stability.

5. Prevention of Recurrence

  • Maintain Rotator-Cuff & Scapular Strength
    Ongoing strengthening of the “dynamic stabilizers” is the single best way to protect your shoulder from future dislocations.
  • Avoid High-Risk Positions
    Be cautious with extreme external rotation + abduction (“cocking” phase) in overhead sports until full strength and control are restored.
  • Regular Check-Ins
    Periodic follow-ups with your therapist or surgeon help catch any weakness or range-of-motion deficits early.

Important Reminders

  • Follow-Up is Crucial: Stick to your appointment schedule for imaging and therapy progress checks.
  •  Listen to Your Body: Mild discomfort is normal when rebuilding strength, but sharp pain or feelings of instability warrant immediate rest and re-evaluation.
  • Individual Variability: Timelines may be shorter or longer depending on your age, tissue quality, if it’s your first versus a recurrent dislocation, and concomitant injuries (e.g., Bankart lesions, Hill–Sachs defects).
  • Recurrent dislocations (>3) may require surgical treatment.

    Always refer to the tailored plan your healthcare team prescribes. If you ever feel your shoulder “giving way” or if pain/swelling spikes suddenly, seek medical attention right away.

    DISCUSS YOUR TREATMENT PLAN IN DETAIL WITH A SHOULDER/SPORTS  SPECIALIST FOR RETURN TO SPORTS

     

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