You Recently Dislocated your Shoulder, What you can expect During Recovery – Perspective from a Doctor of Physical Therapy

What is a Shoulder Dislocation?

It is important to first understand the difference between a shoulder dislocation and a shoulder subluxation. A subluxation is when the head of the humerus shifts forward or backwards enough to slide past the edge of the socket portion of the joint but does not remain outside the joint capsule and instead returns to its original position. A shoulder dislocation is classified as the head of the humerus shifting outside of the shoulder socket or joint capsule and remaining out of it, requiring it to be relocated into place.

Acute Phase (0-72 hours)

You have now dislocated your shoulder and have gone to the ER to have it relocated. You can expect to be put in a sling for the first few days up to a couple of weeks afterward to protect the shoulder and mitigate any residual pain. You will have pain with movement and find it difficult to comfortably reach behind you or out to the side as these positions put you at a higher risk of re-dislocating your shoulder.

Plan to primarily rest it and use ice in increments of 15-20 minutes to help decrease any swelling or edema in the area as well as provide some pain relief. I recommend sleeping on your back or unaffected side as it will be very uncomfortable attempting to sleep on the affected shoulder.

Your MD at the ER will likely prescribe you pain medications which I recommend following per your MD’s instructions. Depending on the severity, they will likely prescribe NSAIDs (e.g., Ibuprofen).

Early Rehabilitation Phase (1-4 weeks)

Plan to begin Physical Therapy and initiate gentle range of motion exercises. Your emphasis will be to return to having equal range of motion between both shoulders that is pain-free. It will be important to avoid aggressive ROM exercises as you will want to avoid potential re-injury or dislocation.

You will also begin with isometric strengthening exercises that will help activate the muscles in your shoulder but avoid putting them through a full range to help decrease any apparent irritation or discomfort.

Progressing Rehabilitation (4-8 weeks)

Hopefully, you have regained most if not all of your range of motion and you can begin more aggressively strengthening your shoulder and the muscles that help support the shoulder joint itself. You will want to focus on your rotator cuff and upper/mid-back muscles that help support the shoulder blade as these will allow you to comfortably reach overhead and support your shoulder without significant feelings of instability.

You will also begin to load the shoulder joint and work on joint proprioception and stability through approximation such as in a tall plank or push-up position. Having good shoulder proprioception is key for helping prevent any further dislocation or injury.

Advanced Rehabilitation (8-24 weeks)

You will continue to progressively load the shoulder and increase resistance, volume, and load per your physical therapist’s discretion and emphasize sport-specific movements that you may want to return to doing. This could include throwing a ball, swinging a racket or golf club, or performing more compound movements to return to weight lifting in the gym.

Long-Term Rehabilitation (>24 weeks)

This is arguably the most important stage in being that it is significantly important to maintain your exercise routine and continue progressing your strength independently to hopefully avoid any future injuries or dislocations. You will want to build into your regular weekly routine to continue strengthening the shoulder muscles.

As always, each recovery process will look different depending on the individual and their prior level of health and fitness as well as their consistency with performing their home exercise program. This hopefully can be used as a general guideline on what to expect during your rehab process, but make sure to follow your personalized rehab program that your Doctor of Physical Therapy will create with you.