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
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Follow-Up is Crucial: Stick to your appointment schedule for imaging and therapy progress checks.
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Listen to Your Body: Mild discomfort is normal when rebuilding strength, but sharp pain or feelings of instability warrant immediate rest and re-evaluation.
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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).
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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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