The shoulder is a ball and socket joint. The arm bone provides the ball (head of humerus) and the shoulder blade provides the socket (glenoid fossa). Shoulder subluxation occurs when the ball moves out of the socket but does not completely come out. A shoulder dislocation occurs when the ball completely comes out of the socket. The shoulder most commonly subluxes or dislocates forwards and down but it can also sublux/ dislocate backwards.
Risk factors for shoulder subluxation and/ or dislocation
- General hypermobility- this can be assessed using the Beighton Score
- Excessive repetitive shoulder motions e.g. swimming, throwing
Signs and symptoms of Shoulder subluxation and/ or dislocation
- Feeling that the “shoulder came out”
- Pins and needles/ numbness down the arm
- Pain in the shoulder
- It may spontaneously pop back in or you may require some help
What does the science say?
- People who dislocate at the age of 20 have a 90% chance of re- dislocation. Surgery as a treatment option may be worth exploring in this demographic
- People who dislocate at the age of 50 have less chance of re- dislocation
- Multiple dislocations may cause fractures at the humeral head or glenoid fossa
- Physiotherapists from the Melbourne Shoulder Group (Lyn Watson) have developed a well- researched and effective rehabilitation program for multidirectional instability that could be used to help you return to sport see: https://pubmed.ncbi.nlm.nih.gov/29048942/
How can Physiotherapy help?
Your Physiotherapist will be able to:
- Help you identify aggravating activities
- Help you identify positions of comfort
- Assess your hypermobility score
- Provide manual therapy to reduce pain and overactivity in muscles around your shoulder
- Identify the biomechanics of your shoulder joint and guide you through strengthening and scapular stabilisation exercises to improve them
- Take you through the Lyn Watson multidirectional instability program
- Discuss and provide information regarding stabilisation surgery