From the Guidelines
After a recent shoulder dislocation reduction, patients should avoid above chest level activities, including shoulder abduction, external rotation, and extension, for at least 3-6 weeks to allow healing of damaged ligaments and capsular structures. This recommendation is based on the principles of fracture management, which emphasize the importance of restricting certain activities to prevent further injury and promote healing 1. Although the study focuses on fragility fractures, the concept of restricting activities to prevent further injury can be applied to shoulder dislocation management.
Key restrictions include:
- Avoiding above chest level activities
- No heavy lifting, pushing, or pulling
- No overhead activities
- Keeping the arm in a sling or immobilizer, particularly while sleeping
- Gentle pendulum exercises can begin within the first week, followed by progressive range-of-motion exercises under the guidance of a physical therapist.
Pain management is also crucial during this period, and may include NSAIDs and ice application to reduce inflammation. It's essential to follow these restrictions to minimize the risk of re-dislocation and promote optimal healing. The healthcare provider will guide the patient on the progression of activities and exercises based on individual healing and strength recovery.
From the Research
Shoulder Restrictions after Dislocation
After a recent reduction of a shoulder dislocation, it is essential to follow specific shoulder restrictions to promote proper healing and minimize the risk of recurrent dislocation. The recommended restrictions may vary depending on the individual case and the treating physician's preferences.
Immobilization
- Immobilization in internal rotation with a sling is a common approach, but studies have shown that immobilization in external rotation may not provide a significant benefit in reducing recurrent instability 2, 3.
- The duration of immobilization is also crucial, with some studies suggesting that immobilization for longer than one week may not be necessary for younger patients 4.
- However, other studies recommend 3 weeks of complete immobilization for patients under 30 years old to reduce the risk of redislocation 5.
Rehabilitation
- A physical rehabilitation program can be started 2 weeks after the shoulder dislocation, focusing on progressive resistive loads and exercises to improve joint strength and range of motion 6.
- The program should be tailored to the individual's needs and may include exercises using elastic bands and weights, 5 days a week, for a duration of 6 weeks 6.
Activity Restrictions
- Patients should avoid heavy lifting, bending, and twisting, as well as contact sports or activities that may put the shoulder at risk of reinjury.
- It is essential to follow the treating physician's specific instructions and guidelines for activity restrictions and rehabilitation to ensure proper healing and minimize the risk of complications.