Friday, 1 March 2013

Shoulder Dislocation / Shoulder Instability

Shoulder Dislocation / Shoulder Instability



Shoulder Dislocation / Shoulder Instability

What is Shoulder Dislocation / Shoulder Instability?

The shoulder (gleno-humeral joint) is a ball and socket joint and is the most mobile joint in the body. It is largely dependent on its surrounding soft tissues to hold it in place.  When the ball displaces out of the socket completely, this is called a dislocation. When the ball moves in the socket beyond its normal capacity, but doesn’t leave the socket, this is called shoulder instability. Dislocations tend to occur due to a trauma or maneuver that pushes the arm beyond its normal range of motion.

How long will it last?

If a true dislocation has occurred it will mean tissues of the shoulder have been torn or damaged and this may involve the ball (humeral head), the socket (the glenoid or the cartilage in the socket called the labrum), the ligaments or your rotator cuff. In a young person who wants to perform overhead or contact sports there is a high chance it will dislocate again and surgery may be considered. In an adult, there is less of a chance of re-dislocation and rehabilitation through physiotherapy will be beneficial to avoid surgery.

Symptoms

The symptoms of shoulder dislocation or ongoing shoulder instability are:
  • A sudden pop. The shoulder may relocate by itself and you feel another pop.
  • A sudden weakness in the arm or a ‘dead arm’. Pins and needles may also follow.
  • Apprehension with twisting your shoulder and fear that it may ‘pop’ out.
  • Weakness / pain with throwing.

Suggestions for managing Shoulder Dislocation and Shoulder Instability

  • If you are unsure if your shoulder is still dislocated contact us during business hours for advice and to make an appointment or call our after hours emergency number for instructions and immediate advice.
  • Taping from your physiotherapist or the use of a sling short term to improve your shoulder posture in the early stage and avoid re-dislocating.
  • Gentle exercises to strengthen the scapula (shoulder blade) muscles can commence after 3 days and gradually improving the strength of your rotator cuff muscles should commence early to avoid weakness.
  • If you have been injured at work or in sport, our practitioners have approved conditioning programs for your shoulder dislocation that will get you back on track sooner with your tailored exercise plan for you. Your physiotherapist may also recommend Massage Therapy or Acupuncture to assist in reducing pain and improving movement
  • Your practitioner may refer you to a Sports Physician for further investigations if your shoulder instability does not respond in our suggested time frames. Sometimes surgery is necessary for a functional recovery.
  • Resting your shoulder from all movements for 4-6 weeks is not recommended.

Rotator Cuff Injury

What is Rotator Cuff Injury?

The shoulder is at risk from injury in many activities. The rotator cuff can be injured through overuse or through trauma. Rotator cuff tendinopathy is common in overhead sports as well as any repeated manual tasks of reaching or lifting. Rotator cuff tears can occur if the tendons are overloaded with both repetitive tasks or a sudden movement. Occasionally a calcium deposit may form in the rotator cuff. We call this calcific tendinopathy.

The rotator cuff tendons are also susceptible to the process of aging. As we get older, the rotator cuff tendons degenerate and weaken. A rotator cuff tear can occur due to this degeneration alone, or when the weakened tendons are stressed during activities or accidents.

How long will it last?

Recovery from Rotator Cuff Injury depends on the severity of the injury. In most cases of rotator cuff pain, a conservative program of physiotherapy guided exercises and massage therapy or myotherapy will be suggested to help improve the pain associated with the injury. Your practitioner at The Sports Injury Clinic will recommend you see a Sports Physician or your GP for further investigation if pain persists for greater than 6 weeks from the start of treatment.

Symptoms

The symptoms of Rotator Cuff Injury are:
  • Pain or aching in the shoulder, often referring down the side of the arm. Pain may refer to the elbow.
  • Pain that is aggravated by lifting with an outstretched arm or twisting (hand behind back / putting on a seat belt / taking off a jumper).
  • Pain with laying on the shoulder at night.
  • Sometimes a catching or ‘arc’ of pain with lifting arm above head.
  • Weakness / heaviness in the arm with activities.

Suggestions for managing Rotator Cuff Injury

  • Staying active as advised by your physiotherapist and modification of how you use your arm. The practitioners at The Sports Injury Clinic will show you ways of improving how you can use your shoulder with advice and instruction. Keeping your shoulder back and your thumb pointing ‘up’ with lifting is a good start!  Click here for programs to assist with your Rotator Cuff Injury.
  • Taping from your physiotherapist to improve your shoulder posture in the early stage. This assists in teaching you how to use the correct muscles and assists in reducing pain in the rotator cuff.
  • Gentle exercises to strengthen the scapula (shoulder blade) muscles and gradually improving the strength of your rotator cuff muscles.
  • If you have been injured at Work or in Sport, our practitioners have approved conditioning programs that will get you back on track sooner with your tailored exercise plan for your rotator cuff injury. Your physiotherapist may also recommend Massage Therapy or acupuncture to assist in reducing pain and improving movement.
  • Your practitioner may refer you to a Sports Physician for further investigations if your rotator cuff injury does not respond in our suggested time frames.

Professional treatment options

Contact us now for immediate advice regarding Rotator cuff injury.