Conservative Management of Shoulder Dislocation & Subluxation
Shoulder dislocations and subluxations are common injuries, especially among athletes and individuals with hypermobility. A full dislocation occurs when the humeral head completely leaves the socket (glenoid), while a subluxation is a partial dislocation where the joint slips out but spontaneously returns. Proper rehabilitation is essential for preventing chronic instability and ensuring full recovery.
Conservative Management
Acute Phase (0–3 Weeks) - Protect and Reduce Pain
Reduction: A dislocated shoulder must be manually relocated by a healthcare professional. Subluxations often self-reduce.
Immobilisation: A sling may be required for 1–3 weeks to allow healing, especially for first-time dislocations.
Pain and Inflammation Control: Apply ice for 15–20 minutes every few hours and take NSAIDs as needed.
Early Range of Motion (ROM) Exercises: Avoid excessive external rotation and overhead movement initially.
Subacute Phase (3–6 Weeks) - Restore Mobility & Strength
Pendulum Exercises: Stand and lean forward, letting the affected arm dangle. Gently swing it in small circles.
Passive External Rotation Stretch: With the elbow at 90 degrees, use the opposite hand or a stick to gently rotate the forearm outward without pain.
Isometric Rotator Cuff Exercises:
Internal Rotation: Press your hand against a wall without moving the arm.
External Rotation: Push the back of your hand against a wall while keeping your elbow tucked.
Scapular Stabilisation:
Scapular Retraction: Squeeze the shoulder blades together and hold for 5 seconds.
Wall Slides: Place your forearms on a wall and slowly slide them up while keeping your shoulder blades engaged.
Strengthening Phase (6–12 Weeks) - Build Stability
Resistance Band Rotator Cuff Strengthening:
External Rotation: Attach a resistance band to a fixed point and rotate your arm outward.
Internal Rotation: Pull the band inward toward your stomach.
Scapular Strengthening:
Rows: Use a resistance band or cable machine to perform rowing movements.
Prone T-Y-I Raises: Lying face down, lift your arms into T, Y, and I positions to strengthen the shoulder stabilisers.
Proprioception Training:
Closed-Chain Exercises: Perform weight-bearing exercises like wall push-ups or quadruped shoulder taps.
Balance Training: Use an unstable surface (e.g., BOSU ball) while performing arm movements.
Return to Activity Phase (3+ Months) - Prevent Recurrence
Sport-Specific Drills: Gradual return to overhead or contact sports with supervised training.
Plyometric Training: Medicine ball throws, controlled overhead catches.
Functional Strengthening: Compound movements like push-ups, pull-ups, and shoulder presses.
Will There Be Constant Instability?
Recurrent instability depends on various factors:
Younger patients (<25 years old) have a higher risk of recurrence.
Athletes in contact sports face greater instability risks.
Structural damage (labral tears, ligament laxity) may require surgical intervention.
Proper rehabilitation significantly reduces recurrence by improving shoulder stability and neuromuscular control.
Prognosis
Good for first-time dislocators with proper rehab, especially in older adults.
High recurrence risk (70–90%) for young athletes without structured strengthening.
Surgery may be needed for persistent instability, with procedures like labral repair or capsular tightening.
Final Thoughts
Recovering from a shoulder dislocation or subluxation requires patience, consistency, and proper guidance. Following a structured rehab plan helps restore strength, stability, and function, reducing the risk of future dislocations. If you’re experiencing persistent instability or pain, consulting a chiropractor or physiotherapist can ensure a tailored approach for your recovery.
Need personalised rehab advice? Book an appointment with Epoch Health today!