The husband of one of my clients dislocated his shoulder a month ago. To my surprise, he can still barely move his arm or shoulder in any way. He has been in a sling since the accident. Do you think I could be of any help in between or after sessions with the physio, and if so, how?
Even the most skilled physio would find this case challenging (from the information provided). The shoulder joint is kinetically very unstable, which allows for the extreme freedom of motions observed. The biggest obstacle he’ll face is regaining normal limits of motion, particularly with his extended bout of immobilization. Many studies have shown that a muscle’s resting length and length/tension properties will change if the muscle is in a lengthened or shortened position for an extended period of time. While in the sling, his shoulder was in a position of adduction and internal rotation. It will be difficult to get the abducted and externally rotated motion back.
You have already helped him greatly by referring him to a physio. Persons trained specifically in joint injury and rehabilitation best handle these injury types. You can assist him in training his core, balance, lower extremity flexibility and cardiovascular fitness – all within the limits of pain in the shoulder. By improving these areas, you can indirectly improve the function of his shoulder. Musculature of the “core” is predominantly Type I fibers (slow twitch). These fiber types are postural in design and can be trained daily. However, prior to initiating any external exercise program, you must consult with the physio for any contraindications.