From the Research
The recommended rehabilitation protocol for a 59-year-old patient following an anterior inferior shoulder dislocation typically involves a three-phase approach over 12-16 weeks, prioritizing pain management, progressive range of motion, and strengthening exercises to minimize the risk of recurrent instability and rotator cuff injuries. The protocol should start with immobilization in a sling for 3-4 weeks to allow healing of the injured tissues, during which gentle pendulum exercises and passive range of motion within safe limits can begin after the first week, as suggested by 1. Key considerations include:
- Phase one (weeks 1-4): Immobilization and initial healing
- Phase two (weeks 4-8): Progressive range of motion and gentle strengthening
- Phase three (weeks 8-16): Progressive strengthening of the rotator cuff and scapular stabilizers Pain management is crucial and typically includes NSAIDs like ibuprofen (400-600mg three times daily) for the first 1-2 weeks, with ice therapy for 15-20 minutes several times daily, as part of a comprehensive approach to rehabilitation 2. It's also important to note that the position of immobilization, whether in internal or external rotation, does not significantly impact the recurrence rate, as indicated by studies such as 3 and 4, but the most recent and highest quality evidence should guide clinical decisions. Given the age of the patient and the nature of the injury, careful monitoring and adjustment of the rehabilitation protocol based on pain and functional improvement are essential to avoid aggravating symptoms or causing re-injury, emphasizing the importance of individualized care in rehabilitation protocols 5, 2.