What are the restrictions and treatment for a patient with a right shoulder dislocation?

From the Guidelines

For a patient with a right shoulder dislocation, immediate treatment involves closed reduction to restore normal joint position, followed by immobilization in a sling for 1-3 weeks depending on age and risk factors. Pain management typically includes NSAIDs like ibuprofen (400-600mg every 6-8 hours) or naproxen (500mg twice daily), and sometimes short-term opioids such as hydrocodone/acetaminophen 5/325mg every 4-6 hours as needed for severe pain 1.

Key Considerations

• Activity restrictions are essential: patients should avoid external rotation, abduction, and extension of the shoulder during the immobilization period.
• After the initial immobilization, a progressive rehabilitation program should begin, focusing first on pendulum exercises and passive range of motion, then advancing to active range of motion and finally strengthening exercises over 6-12 weeks.
• Young, athletic patients (under 30) have higher recurrence rates (up to 90%) and may benefit from earlier surgical consultation 1.
• Patients should be educated about avoiding positions that place the arm in abduction and external rotation, as this position increases redislocation risk.

Imaging and Further Evaluation

• Radiography is a useful initial screening modality for acute shoulder pain of all causes, including shoulder dislocation 1.
• The imaging algorithm should always begin with an assessment of the hardware components, alignment, and surrounding osseous and soft-tissue structures 1.

Treatment Goals

• The goal of treatment is to allow proper healing of the torn anterior labrum and capsule (Bankart lesion) that typically occurs during anterior dislocations, which account for about 95% of all shoulder dislocations.
• Treatment should prioritize minimizing morbidity, mortality, and improving quality of life, with a focus on preventing recurrent dislocations and promoting full recovery of shoulder function.

From the Research

Restrictions with Right Shoulder Dislocation

• Patients with a right shoulder dislocation may experience restrictions in their daily activities, particularly those that involve heavy lifting, throwing, or overhead movements 2, 3.
• Immobilization in a sling or brace is often recommended to allow the shoulder to heal and reduce the risk of recurrent dislocation 2, 4.
• The duration of immobilization can vary depending on the patient's age, activity level, and the severity of the dislocation, but typically ranges from 1-6 weeks 3, 4.
• Patients may need to avoid certain activities, such as contact sports or heavy lifting, for several months after the injury to allow the shoulder to fully heal 5, 6.

Treatment for Right Shoulder Dislocation

• The primary treatment for a right shoulder dislocation is closed reduction, which involves manually manipulating the shoulder joint back into place 2, 3.
• Immobilization in a sling or brace is often used to support the shoulder and allow it to heal 2, 4.
• Physical therapy may be recommended to improve range of motion, strength, and function in the shoulder joint 5.
• In some cases, surgery may be necessary to repair any damaged tissues or stabilize the shoulder joint 6.

Rehabilitation and Recovery

• A rehabilitation program that includes progressive resistive exercises and range of motion exercises can help improve strength and function in the shoulder joint 5.
• Patients may need to modify their activities to avoid putting excessive stress on the shoulder joint, particularly during the initial healing phase 3, 4.
• Return to sports or other high-level activities should be gradual and guided by a healthcare professional to minimize the risk of recurrent dislocation 6.