PT on the Net Research

Past Dislocated Shoulder


Question:

I was recently contacted by a client who dislocated his shoulder in his mid teens (he is now 25 years old). The shoulder has popped out four or five times since then. Would strengthening the muscles around the head of the humurus prevent this from happening, and if so, are there any exercises I should avoid? The client has not trained for a number of years. I would greatly appreciate your help.

Answer:

When there has been a dislocation at that age and that many subsequent dislocations since then, the shoulder joint is most likely damaged in terms of the labrum (which creates stability at the shoulder) and perhaps the articular cartilage as well. When there is damage to such structures, even with strengthening exercises, there will still be risk of future dislocations and the potential chance of eventual arthritis. In my experience and in studies I have read, exercise programs have not had a good success rate in terms of preventing future problems, especially if the person is young and active, as in this case. Strengthening the supporting musculature can always help, but now there are arthroscopic surgeries (like the common Bankhart procedure) that are quick and relatively short in terms of recovery that could also help this person to not only make sure the fear of dislocation is gone but return to a full training regimen.

In synopsis, I would be very careful in the case of this client. With the most common dislocations, I would avoid any exercises that involve abduction and external rotation of the shoulder and any others where he demonstrates apprehension performing. At this time, begin with exercises that create stabilization at the joint and focus on internal rotation as well. If you begin the training and he demonstrates marked apprehension and/or pain in the affected shoulder, an orthopedic consultation may be necessary.