Principles of treatment

1. traumatic shoulder dislocation: 2. posttraumatic recurrent shoulder dislocation 3. habitual shoulder dislocation:

Surgical therapy is usually performed: for anterior – lower first luxation
As a rule, conservative therapy is applied with increasing age and reduced sporting and physical activity.
Surgical treatment is usually: for anterior – lower initial luxation in unidirectional, anterior instability in younger, physically active patients (due to the high rate of dislocation)
For anterior – lower first luxation
For unidirectional, anterior instability
In younger, physically active patients (due to the high rate of dislocation)
As a rule, conservative therapy is applied with increasing age and reduced sporting and physical activity.
For anterior – lower first luxation
For unidirectional, anterior instability
In younger, physically active patients (due to the high rate of dislocation)
In rare cases of dislocation and in cases where there are no significant functional limitations, as well as in older patients, conservative treatment is generally used.
Athletically active patients with frequent recurrent dislocations are usually treated surgically.
All in all, the therapeutic measure thus depends on the number of dislocations, the sporting activity and the extent of the subjective and objective impairment.

Conservative therapy of shoulder dislocation

The forms of treatment for the various forms of shoulder dislocation have already been discussed in the last section. In the following section, various therapeutic measures are presented. If your treating physician advises you to use a conservative therapy for shoulder dislocation, he will usually also inform you about special behavioral patterns for everyday life, but also – if necessary – for work and sports.

You should know that continuously performed self-exercises for muscle strengthening and joint stabilization are particularly important and can only be performed by you beyond the conservative therapy. You yourself are therefore significantly involved in the therapy and should take this fact seriously. 1) Drug therapy: Pain can be relieved and swelling reduced by means of drug therapy.

In order to reposition the shoulder, pain can be relieved and tense muscles loosened from the outset so that repositioning is easier (= symptomatic administration of painkillers). NSAIDs (= non-steroidal anti-inflammatory drugs) can also be given orally. Diclofenac, Celebrex, Ibuprofen, etc.

are examples. 2 Orthopaedic technology: The severity of the disease has already been discussed above. These degrees of severity naturally also differ in their therapeutic approach.

The application of orthopedic technology also varies in the three degrees of severity. In the following, we will show, for example, when the different orthopedic techniques are used: 3. Physical therapy: After the immobilization following repositioning has been overcome, an attempt should be made to strengthen the shoulder girdle muscles as part of a physical therapy.

Especially those muscle groups that counteract the direction of dislocation are of great importance. Muscle strengthening exercises must – as already described above – always be continued independently. The own initiative is therefore an essential aspect here.

Your physiotherapist will show you joint-centered exercises to strengthen your muscles.Depending on the point in time and the stability achieved, further measures of physical therapy may include: –> Continue to the topic of shoulder dislocation surgery

Gilchrist Association
Thoracic abduction splint or cushion
Antiluxation Orthoses
Local cooling (in acute stage)
Movement exercises to strengthen the musculature
Exercise pool
Special physiotherapeutic techniques (e.g. PNF)

Physiotherapy must take place at the right moment of treatment. As a first measure, the shoulder joint is immobilized so that it can recover, injuries can heal and the pain can subside as far as possible. Only then should physiotherapy be used to maintain freedom of movement in the joint, accelerate healing and strengthen the shoulder girdle in such a way that further shoulder dislocations are prevented.

First, the muscles must be loosened and stretched. To do this, bend forward and let the arms hang. Then the muscles can be loosened by small circular movements.

Physiotherapy then teaches how to use certain methods not only to strengthen the muscles but also to better perceive and influence one’s own movements. Becoming aware of certain movements, for example an upright posture without a hump, is an important step in combating incorrect, harmful movements. One such procedure in physiotherapy is PNF, the proprioceptive neuromuscular facilitation.

Here, too, it is mainly a matter of analyzing previous movements and correcting and practicing motor processes as precisely as possible. A bandage is an elastic piece of fabric that should completely surround the affected joint region and is adapted to the body shape. Various models can be considered for the therapy of shoulder dislocation.

A tight bandage can connect the upper arm with the trunk in order to immobilize and protect the joint in the acute initial phase. Modern elastic bandages surround the shoulder joint and are fixed across the chest under the opposite arm. The principle of these bandages is to transfer the weight of the arm completely to the chest and thus relieve the affected shoulder.

These bandages restrict the freedom of movement only slightly, but stabilize, guide and splint the shoulder joint. In contrast to tape bandages or kinesio-tapes, they completely enclose the shoulder and can guarantee adequate stabilization. Kinesio-Tapes are elastic adhesive bandages.

The kinesio-tapes represent an alternative medical treatment method, which is mainly used in sports medicine and orthopedics, but also in the treatment of internal diseases. The kinesio-tape is applied from the outside to the skin above the affected area. This must be done by a physiotherapist or doctor or even after long practice and under professional guidance.

The tape should have several functions. It offers stability in the joint in case of muscular injuries due to external tensile stress. At the same time, it is elastic enough not to restrict the freedom of movement of the joint.

It thus strengthens the joint function against pressure and tension and splints the normal movement in the shoulder. Whether it provides sufficient stability to prevent shoulder dislocations in the shoulder is controversial. In this respect, the kinesio-tape is inferior to the normal inelastic tape bandage.

At the same time, however, the kinesio-tape is said to have other functions. It is supposed to warm the bonded area and stimulate the blood circulation at the same time, which should accelerate the healing process of injuries and inflammations. In addition, the body’s own pain defense system is to be stimulated, which makes the shoulder dislocation more bearable.

The Kinesio-Tape can be used for therapy as well as prevention of shoulder dislocation. Especially in the physiotherapy after a dislocation, the Kinesio-Tape can influence the muscle perception and promote muscle growth. One of the major problems in the dislocation of the shoulder joint is the prevention of further dislocations and the continued therapy.

Even a single dislocation is enough to change the muscles and cartilage of the joint, sometimes even to damage them, so that the bone can easily jump out of the socket again and again in the future. In the entire physiotherapeutic treatment, great importance is attached to avoiding jerky, provocative movements. However, an important treatment method is the strengthening of the shoulder girdle muscles.

Stronger, wider muscle bellies fix the bone in its joint and block the path in the event of dislocation.In a first exercise the outer arm lifters are strengthened. To do this, stand upright and raise the stretched arms at the sides and above head height until they touch above the head. In addition, the exercise can be made more difficult with weights in both hands.

If dumbbells are not available, the exercise can also be performed with full water bottles. The exercise with the water bottles can also be varied to reach other muscles in the shoulder girdle. Instead of bringing the arms together above the head, they can also touch each other at head level in front of the body and then be moved back as far as the movement of the shoulder blades allows.

Also in a standing position, the arms can be raised to head level in another exercise. Then let the arms circle in a small radius, about 10cm forward, down, back and up. To keep your balance, all exercises are performed simultaneously on both sides. Since these exercises are an important part of therapy, they should first be instructed by a doctor or physiotherapist. For better exercise, it is advisable to purchase fitness bands, weight bands or dumbbells so that the muscle training can be individually adapted.