The shoulder joint (glenohumeral joint) is a ball and socket joint with a large ball (humeral head) and a shallow socket (glenoid). This biomechanical set up makes the shoulder joint highly mobile and at risk of dislocation (abnormal separation of the joint) or subluxation (partial dislocation). Most of the time these injuries require high amounts of force to occur, however in rare cases where a person has significantly lax ligaments these injuries may occur spontaneously.
Pain, swelling and a feeling of instability in the shoulder are common symptoms following a subluxation. A dislocated shoulder joint requires medical reduction (relocating the ball and socket) and once this has been completed the joint may need to be immobilised in a brace or sling. It is imperative after both subluxation and dislocation that appropriate shoulder rehabilitation is completed with your sports physiotherapist to prevent re-injury. In some circumstances, surgery is indicated and your physiotherapist and doctor can discuss this with you.
Shoulder instability is common in people who use their shoulder through the full range with increased load, such as in throwing or racket sport athletes, gymnasts, circus performers and male dancers (lifting their partner).
Pain and a feeling of apprehension or “popping out” are common symptoms associated with shoulder instability. This condition may be developed over time and it is common following a dislocation or subluxation of the shoulder (glenohumeral joint).
Physiotherapy management involves soft tissue and joint techniques, taping and exercises to correct the shoulder blade position and strengthen the shoulder joint. Technique analysis of your aggravating activity is also important and your physiotherapist can guide you through this in conjunction with your coach.
All orthopaedic surgery requires rehabilitation to assist the recovery from surgery to appropriately guide and progress activity levels without compromising the surgery just undertaken.
Post-operatively, there is often pain and swelling and these must be controlled immediately to minimise any inhibition of surrounding muscles and therefore prevent compensatory muscle and biomechanical activities developing.
Your sports physiotherapist works in conjunction with your surgeon’s wishes to ensure a safe and appropriate return to activity. Your treatment will involve swelling and pain management strategies, biomechanical retraining, strengthening and ultimately a return to your chosen activity.