Shoulder Luxation: preventing complications with physiotherapy

Luxation of the shoulder (or dislocation) is a very painful injury that occurs when the head of the humerus pops out of its cavity following a sudden impact, such as falling on an extended arm.

Shoulder luxation can cause various injuries to the joint, including tears in the soft tissue (ex.: ligaments), lesions or tears in the shoulder’s stabilizing muscles, fractures and nerve and vascular lesions.

Over 90% of shoulder luxations are said to be “anterior”, meaning that the head of the humerus pops out of its cavity in a forward direction. This predominance of the anterior luxation is due to the joint’s configuration, which predisposes the humerus to dislocate forward rather than backward as the result of a blow or impact.

The Symptoms

• Acute shoulder pain
• Bruising and edema
• Noticeable alteration: the head of the humerus seems dislodged toward the front
• All movements are limited, but especially internal rotations
• Feeling of muscle spasms in the shoulder during “at risk” movements, such as shoulder elevation or external rotation; the spasm is felt at the end of the movement.

Immediate Treatment

When a shoulder luxation occurs, an immediate trip to the emergency room is required to have the joint “reduced” (put back in its socket) by a health care professional. The shoulder will then be immobilized in a sling or splint for a period of three to six weeks.

Avoiding Complications with Physiotherapy

Physiotherapy is the treatment of choice for anterior shoulder luxation, as it:

• Eliminates pain
• Helps recover shoulder joint mobility
• Ensures proper muscle strength in all movements
• Provides proper stability of the joint
• Helps the shoulder regain function as well as the ability to tolerate effort
• Avoids recurrences and chronic instability.

If the injury receives no treatment other than the reduction, there is a high risk of long term complications, including chronic instability that can cause one or several recurring luxations, as well as osteoarthritis in the shoulder.

The Various Treatments used in Physiotherapy

• Preventing a recurrence: the physiotherapist will show you which shoulder movements to avoid
• Reducing pain: analgesic treatments, such as the application of ice, along with electrical nerve stimulation (TENS)
• Improvement of mobility: application of heat, movement of the shoulder in a careful swinging motion (to loosen and warm up the shoulder before rehabilitation exercises), mobility exercises and manual therapy
• Muscle strengthening and strength gains with the use of weights and rubber bands
• Proprioceptive therapy: this treatment is done at the end of the rehabilitation and allows for selective muscle strengthening, proper neuromotor optimization and a progressive retraining of the shoulder as it relates to the work or sport-related movement.

Resuming Activities

In general, sports activities can be resumed two to three months after the injury where “at risk” activities are concerned (for example baseball or football), although it can sometimes take up to six months. It’s very important to allow enough time before resuming activities in order to avoid the potential complications mentioned above.

If you have suffered a shoulder luxation and would like to fully restore your shoulder’s function and avoid long term complications, contact us to consult one of our health professionals.