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What are the best shoulder dislocation treatment techniques?

Physiotherapy of dislocated shoulder
By Bartosz Dąbrowski

By Bartosz
(Contact Me)

Hints Sept. 19, 2019 Slovakia Oravice 2019 Hints

We were about to finish skiing for the day. On my last round, I jumped and hit the ground very hard. And my dislocated shoulder story has begun.


How does the shoulder gets dislocated? 

The arm receives impact so strong that the bone forcefully moves outside of its normal area causing the muscles around to tear off. In result, bone's head stays outside of its socket - most of the times it can't return without medical intervention.

Shoulder dislocation X Ray

dislocated shoulder

X-Ray photo showing dislocated arm. The bone head is much lower than it supposed to be.

Every shoulder dislocation is a little bit unique in its kind - type and range of tissue damage may vary. Some people say they didn't even wear a sling. In my case, I couldn't move my arm an inch and I had large swelling

Table of contents:

  • In the first section, I will describe my biggest concerns about the injury and what it turned out to be in reality.
  • In the section Dislocated Shoulder Q & A, I gathered all the questions I had during my recovery time and provided answers to them.
  • Next, there is the section: Shoulder dislocation recovery tips.
  • Then the list of all the equipment I used in my recovery.
  • Things I don't advise to do.
  • And what are positive aspects of my shoulder dislocation?


Concerns 

fear and dislocated shoulder

© motortion / Adobe Stock

Dislocated shoulder pain

The severest pain I had was for 2 hours while the arm remained in the dislocated position. After my shoulder setting, there was a temporary relief.

Next weeks, it hurt me a lot, and pain killers were necessary even though I have never taken them before. I couldn't sleep in any position, once I slept sitting that which wasn't pleasant as well. The constant feeling of discomfort was driving me crazy.

It was almost like when we have a newborn in house - zero sleep.

Setting the joint

Setting dislocated shoulder

© Fotos 593 / Adobe Stock

It was worrisome, but in painful agony, we don't care. My setting went smooth surprisingly - I didn't feel anything at all. The secret lies within relaxation and deep breathing - only then our muscles would untie, and the bone could jump back on the place in forceless motion.

It looked exactly like on the attached picture. The medic lifted my arm very gently up, and it just popped back in place.

Dislocating again

My most significant anxiety was that the entire internet says 90% of men have this injury reoccurred in the next two years. 

When muscles aren't strong enough joint may become looser and looser over the time causing almost disability. Imagine that we could dislocate it when lifting heavy bags, putting on a t-shirt, opening the door or even when sleeping.

I had a big fear I could end up just like that. The Internet said you have only a 10% chance! It made me very upset.

But what most people don't know it is a choice. When we put more effort into the recovery, chances increase significantly. It is about building balanced and stable muscles through special and often tricky exercises.

My injured arm seems to hang lower than the healthy one

Once muscles start shrinking from lack of movement (about 1-2 weeks), we will notice that collar bone is more significant than usual. It is normal because muscles mass shrinks in the area. And even when the arm is lower than the other one, don't worry - it's not irreversible, it should get back in place after strengthening the muscles again. We can reverse it through exercises. But only when the healing process is over.

I lost the feeling of my skin on my shoulder

It sometimes happens when a nerve is damaged I had it in my case as well. It will seem like it doesn't improve over time then suddenly after 3-5 months, we should feel it again.


Dislocated shoulder Q & A

thinking about shoulder dislocation

© zinkevych / Adobe Stock

I asked myself 100 questions a day related to the injury. I haven't found anything useful on the Internet. Nothing helped there. Reading horror stories about dislocation just demotivated me.

Interestingly, I noticed that people who had this injury reoccurred never mentioned they exercised before. They were just full of "God, why me!?". So that intrigued me into thinking maybe most people aren't really aware of the possible solutions or don't believe in it. This was my main driving force for writing this article.

In case you are that one unlucky person having trouble with recovery for a very long time. I hope to give you a fresh and decent amount of motivation in the form of tips, stories, conclusions and techniques.

Why I can't move my arm even an inch?

Did I injured an important nerve and lost the ability to move? After 2-5 days after injury, I wasn't able to move my arm, except the fingers and forearm. Apparently it was due to body self-protection mechanism after injury. Our body turns off the nerve system in the area, so we are unable to harm ourselves and end up almost numb in this area. Also, the body stiffs muscles in the area to hold bones in one position, just like a stabiliser. It was explained to me by one of my physiotherapists.

Any diet recommendation?

From what I learned from the doctor diet doesn't make the difference. Taking collagen seems pointless as young men are prone to this injury due to high amounts of collagen in their joints making them more elastic and vulnerable.

How fast the muscles shrink?

how-much-muscle-shrink.jpg

I remember that was my first question the next day. I can say they shrink pretty fast. But the shrinking isn't the biggest problem - the stretch and contraction is the bigger problem. My hand was very slim after two weeks with no movement, but I wasn't aware that gaining muscle mass is easy in comparison with getting a contraction and stretch range back. I started very gentle exercises since 5th day after the injury after consulation with doctor.

What are dislocated shoulder symptoms?

Unbearable pain

For instance, when we fall and hurt our leg we do feel strong pain just for a while. But with a dislocated shoulder, this pain doesn't go away. I was laying for a moment thinking this pain will go away in a few seconds. When I noticed the pain is not fading I new something is seriously wrong.

Not able to move

Can't move the arm is one definite symptom of a dislocated shoulder. I was able to move my hand and all fingers but movements involving shoulder weren't possible.

Sticking our collar bone

Since the bone is much lower after the dislocation of symptom is collar bone will be standing out.

If you have a history of dislocated shoulder your symptoms may be different.

Will the visualisation technique help for faster recovery time?

You've probably heard that Olympic athletes are using visualisation to improve performance. I tried that myself. I couldn't move my shoulder, but every day in the initial stage I try to sit in a quiet place put on headphones play favourite tunes and imagine that I'm waving my hand freely. I can't really tell if that helped. It made my physiotherapists smile when I told them about it. Once we even tried it on the session. One thing I noticed was that the muscles became stiffer while I imagined the movements.

What is Anterior shoulder dislocation 

It's when the bone is dislocated forwards. In most cases caused by strong impact. According to Wikipedia 95% of dislocations are anterior including the one I had.

  • In this injury, there is a higher chance to damage the axillary nerve.

How long does a dislocated shoulder take to heal?

No one can guarantee how fast you'll recover. Every dislocated shoulder is different - some of them will tear apart more muscles and some of them less. But your motivation to do the right things can significantly improve the recovery time.

In my case, it took me 18 months to fully recover and feel confident with every activity or sport.

I did shoulder dislocation exercises almost at least every second day for the first six months later 1-3 times swimming per week + some home exercises. On our wedding day I barely could put the hand over my wife height, but we danced and had a lot of fun anyway - this was six months after the accident. I stopped rehabilitation after eight months and continue to focus on swimming instead. When I started swimming in 7 months I wasn't able to fully extend my hand up that made swimming harder but after a few months I got better and better.

Swimming after dislocated shoulder

Swimming after sholder dislocation.jpeg

It's always a good idea to come up with initiative ask physiotherapist if swimming would help you. © LIGHTFIELD STUDIOS / Adobe Stock

When I asked my physiotherapists they said any swimming style will be beneficial for your shoulder unless you don't push it if you feel pain. I asked one of them for breaststroke because was interesting in this style. It is ok for shoulders. But he said to me: it's bad for your pelvis. In breaststroke, legs rotate outward - as most people have a problem with this he said. That was just his opinion he didn't mention any studies in the area. I swim freestyle.

In the year following the accident, I managed to swim more than 100 km (4000 pool lengths ) in freestyle.

Can you run with a dislocated shoulder?

Running half marathon

Running half-marathon in Katowice 2019

I couldn't. The pain was too strong when the arm was shaking in the beginning

In first year I had 2 - 3 situation when I tried to run and felt something really bad in my shoulder when I made a step on uneven ground and lost balance for a split second. It felt really like arm was pushed to near dislocation.

.I imagine that if you start from speed walking and gradually increase the speed and pay great attention to keeping the shoulder stable it could be done. But it could require a lot of patience. 

Since 2nd year of recovery, I can run half-marathons and don't even remember I had ever shoulder problem. 

Can you move with a dislocated shoulder?

Yes, you should safely move when you don't feel pain. The pain should be the boundary when it is still healing the tissue.

It is best to recheck this question with the doctor after they examine you possibly on the first visit.

When will the pain go away?

Magnetic therapy after dislocated shoulder

Magnetic therapy device used after dislocated shoulder © Africa Studio / Adobe Stock

In my case, it was for two months. After two months it finally stopped to hurt, and I could sleep a whole night again. I remember I needed to wake up every couple of minutes to sit as lying was very painful. Once I fell asleep sitting with head between my knees. I couldn't feel my legs for a few minutes after waking up 🙂 .

One thing that helped fight the inflammation and pain were therapies: laser, ultrasounds, magneto- and cryotherapy - after 2-week session pain was gone.

Which shoulder dislocation exercise should I do?

Can't tell you as I don't know if you have the same injury as I had. No one can say to you until you will be examined. Right after the damage you should schedule the appointment with the orthopedist and ask him for an ultrasound scan and advice on exercise. After about one month the doctor will direct you to the rehabilitation stage.

Should I try this online shoulder dislocation exercise?

Shoulder exercise after dislocation

Shoulder exercise after the dislocation

Simple answer - no.  It's not possible to redo any of these exercises only by looking at the computer screen. Usually, these exercises are difficult to do properly. On the sessions, rehab personnel is watching you constantly and I did constantly everything wrong and needed many corrections in my moves.

It's not like a fitness channel. On the rehab appointments, you usually stimulate one muscle at the time.

To summarize my arguments:

  • Must know if stabilization muscles are balanced
  • You probably can't stimulate only one muscle in the back at the time?
  • Must know the force you have to put into exercise to make it effective and safe
  • Someone should monitor the results of each exercise and plan them
  • The best feedback comes from profeessionals

Exercises with dislocated shoulder

When should I start shoulder dislocation exercises?

In my case very soon after a week but the movements were like an inch in one direction. That's why ask your doctor when would be best to start for your injury and what.

When can I return to work after shoulder dislocation?

I returned after 2 weeks but I sit behind the desk all day. I had no insurance and nor the sick leave being self-employed. I had really strong pain of my back from sitting and wasn't effective at work.

So I would say 2 weeks for the office is too soon. But depends on your situation. I would say try to stay as long as possible and as long as the doctor said.

When can I drive after dislocating my shoulder?

My doctor said that there is no law regulating this possibility. It is left to each individual common sense to decide. In theory, I could drive with a dislocated shoulder and a broken leg.

I wasn't driving for the first 2 weeks as I would feel not comfortable. I would advise avoiding driving a car and if you don't have a choice just think 2 times if it's a good idea to drive and if you will be able to react to road situations on time.

Can a dislocated shoulder heal itself

No, Is our shoulder fully healed when all the tissue is regenerated but muscles stay weak or unbalanced and the chance of re-dislocating in future is increased? 

For me, healing means not only tissue regeneration but also building muscle stabilization defence around your shoulder and possibly make it even more resistant for the future than it was before the injury.

How to heal a dislocated shoulder faster?

  • Do ultrasound, laser, chirogenic, and magnetic therapies (they are proven to be effective in a number of studies)
  • If your orthopedist allows it - you could start exercises after a few days (ask them about it)
  • Do homework exercises after consultation with a physiotherapist. 
  • Get equipment and use it: exercise ball, resistance bands, muscle knots massage ball, mat
  • Wear Kinesiology Tapes. Again ask physiotherapist for the best taping technique for your injury
  • Be careful with your shoulder. Remember that re-dislocating is the risk you want to avoid.
  • Start swimming as soon as you can
  • Do muscle stabilization exercises
  • Check your shoulder with as orthopedist in few days after the accident and regularly later


Shoulder dislocation recovery tips

Physiotherapist working with shoulder

Physiotherapist working with the shoulder. © Photographee.eu / Adobe Stock

Seek medical advice soon after shoulder dislocation

You should seek medical advice after a few days the joint had been set in the hospital. It's the opportunity to answer your questions and check how your shoulder heals. After about 4 weeks your doctor should direct you to the rehab. In the hospital, there won't be much time to talk as there are usually several people in the emergency waiting after you.

Find good physiotherapist for shoulder dislocation rehab

I had the disadvantage of having new physiotherapist every week in my first rehab centre. I needed to almost start over with everyone. I didn't like that I felt that my progress could be better if someone understood me and see what works for me from the very beginning. There worked around ten professional (I worked with each of them) + 3 apprentices.

On the positive side, I could ask about their opinions and learn a much more full range of exercises. Physiotherapists aren't all equal - I noticed that some of them are specialised in treating specific injuries and know less about shoulder dislocation.

And also like in life every problem can be solved with many possible solutions, every one of therapist has different exercises they favour. I could see quite a difference after changing the rehab center into a small professional cabinet. In the new place, I was thoroughly analysed for almost the same money. For the first time, they asked me more questions than I asked them! 😉 They seemed to be more passionate about their job and more concerned about my health.

Register to the rehab centre that is not too busy

The physiotherapist saw that I was struggling and advised me to change the rehab centre. That was very generous; I appreciate that. I suppose she was most experienced of them all as she was able to see from a distance and find out of the box solution to my health even though she would earn less! Later, I had 1 - 2 people watching over me - that was a vast improvement in comparison to the previous where there was usually 1 - 2 (rarely 3) patients per physiotherapist.

I think all the professionals I worked with were equally good. The place makes the difference because even if a perfect person wants to help greatly but can't because it's too busy. If you feel that there is something wrong about your sessions best way is, to be honest, and ask the them if they think that you could do better in another place and if they can recommend someone.


Should I buy special equipment for my shoulder recovery?

rehab equipment

© monika / Adobe Stock

There are many good things that you could buy to help the recovery process of your shoulder.

I am fun of Thera-Band company from Ohio, the USA. 

  • They are made from long-lasting and high quality, toxic-free materials
  • The effects of using them are proven in research studies 
  • Producers put a great deal into the safety of their products

I bought all the items below myself and all listed below did contribute to my better recovery. We consulted with my physiotherapist and then observed the results.


Shoulder sling

Sling wore after dislocated shoulder

On the picture: my friends could enjoy the winter holiday but I couldn't

The sling should be comfortable, have the proper size and be stable. I used two slings because after some time one smelled. Also, good addition is the strip you can wrap around your body - this helps during walking preventing additional shaking. I am attaching to selections that are very similar to the one I had:

It's only for the first few weeks depends on what your doctor says.


Exercise Ball

exercise ball for shoulder

© nenetus / Adobe Stock

We can use them instead of chairs for a dynamic position. Because static positions are bad for your spine. They enrich our exercises. Half of my exercises were involving them and I can combine them with other equipment together resistance band + ball + mat it can save time and make exercising more comfortable. I recommend them for exercises for your injury and to continue after you are fully healed especially if you work at the desk. I have two Theraband balls currently red and green. 


Kinesiology Tape for dislocated shoulder

tapes for the shoulder

© AYAimages / Adobe Stock

I could feel the effects of wearing the tapes strapped around my shoulder. I was swimming with them. My muscle tension in area was reduced. Unfortunately straps I had caused a reaction on my skin with a rash so I had to stop using them. Anyway, I recommend them because I saw positive results and physiotherapist said the rash happens only for very few people. 

It is best apply them for first time in presence of your phisotherapist.


Resistance band

Resistance band for shoulder rehab

© Andrey Popov / Adobe Stock

I did exercises with bands every day since the second month and later at least 2 times a week. With the help of your physiotherapist, you will pick exercises best for you. Bands are great because of the huge variety of possible exercises and the ability to increase the difficulty gradually.

The way it works is it causes resistance when stretching. According to many people it's very beneficial for muscles and joints. Further you swing the arm the increasingly more muscle work is required. Compared with lifting weights where muscle effort is same or depends on the angle and can create leverage sometimes bad for joints.


Muscle knots massage ball

The massage ball for shoulder muscle tension

© Printemps / Adobe Stock

It is one of the best dislocated shoulder massage techniques and it's easy to do it at home.

This is my most liked item on the list. Brought me most of the relief. My neck and back muscles were very stiff and it helped me unblock and soften them. 

Massage your back using the wall standing back to it and put the ball in between you and wall and press your back to the wall.  Move up or down this will reduce muscle tension before exercises or after getting up in the morning.

Massage has many benefits. It relaxes the muscles improves blood flow so more oxygen and minerals are flowing. Removes muscle knots common after longer muscle inactivity. 


Exercise mat

The exercise mat

© Microgen / Adobe Stock

We always used the mat for exercises in the rehab centre so I decided to buy one after I finished sessions and I wanted to continue them from home. I use the mat for all kind of home exercises. I have the red color of the mat which is the thickest. I mostly combine mat with exercises on the ball and sometimes just to relax and meditate.


Balance cushion

This item is not directly related to shoulder dislocation but it helped me immensely with correcting my posture by doing workout for body stabilizing muscles. I highly recommend all people spending too much time in front of a mobile phone or office desk to consider exercising using the balance cushion.


What I don't recommend for shoulder dislocation?

I don't recommend shoulder stabilizers

I don't recommend any stabilisation devices that limit your movement unless doctor or physiotherapist advise it. The exception is the sling you should wear for the first few weeks.

But all the stabilizers are bad for you and cause in fact more damage limiting movement and causing the freezing of the joint limiting it's motion more and more which decrease muscle stabilization.

Stablizators may be recommended in some rare cases but generally should be avoided. We should try to use our arms as normal and do not push it too hard when we feel the pain.

Don't recommend the collagen-rich diet

Normally avoid Cola and highly processed foods, eat lots of vegetables and fruits as WHO is advising us.

Collagen gets entirely digested in our stomach so it's a waste of money. In addition, young men often experience joint dislocation because they have too much collagen. It was concluded with age chance lowers probably because collagen density in our body decreases.



On the bright side of the dislocated shoulder

running half marathon

I run Half Marathon in 2018 and 2019, swim ~70 miles a year since the second half of 2016. This year started doing pushups in the year 2019 totalling I did 20856 pushups. Before the injury I did zero.

Posture

I've become aware of my posture problems caused by prolonged sitting and lack of activities. I started to exercise and swim regularly since then. In the long run, I think I'll gain more than I lost - I remember now to look after my posture. This is essential as I usually sit extended hours every day and will probably continue to do so for the rest of my life. I have to know how to handle the muscle stress of sitting. I need to exercise regularly and use tools like an exercise ball to counter the disadvantages of staying in a static position all day long.

Knowledge

I learnt a lot about my body and got to understand myself more. I know what might cause muscle stiffness and how to deal with it. For instance, neck stiffness may indicate that your muscles lack oxygen. It may also be caused by a lack of minerals (bad circulation in muscle), infection (flu) or backbone problem.

Challenge

It was kind of a challenge. I won my health back and I feel good about it. I hope you could think the same about your experience. I returned to sports I used to do a long time ago - I swim now more often than I did years ago.

Your family

I hope you'll be surrounded by your close ones to help and cheer you up. And remember to thank them after all as you'll be suffering and probably become a bit of a pain in the neck to the others 😉

In the head it is

Finally, all the process of healing and rehabilitation takes place mostly our minds. It's like a tactical match or chess game. We must pick up a fight if we want health back. Not only back but even improved! You will must: take a journey, learn new techniques, met new people, do research, make very often fool of yourself if you are new, train, do a plan, note insights, be precise, find balance, handle disappointment, be consistent and creative.


And in the end, every crisis is the opportunity to change your life for the better.


I wish you to be well very soon!

Video recording of my accident

How did it happen?

Together with my wife and friends, we had a wonderful day skiing in the mountains. We were about to go home and on my last run, I jumped and hit the ground very hard. My dislocated shoulder story began. (Video in the bottom section)

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