Best Shoulder Dislocation Exercises for Recovery

After a shoulder dislocation, exercise is a great place to get started with the recovery process. Shoulder dislocation most often requires a period of immobilization to allow the over-stretched tissues of the shoulder joint to heal and resume some semblance of stability. If severe enough, when tears or extreme instability is evident, surgery may be required too. Regardless, at some point you will want to start shoulder exercises to for the best possible outcomes. Keep reading to learn more about the benefits of exercise and find a list of movements to try after a shoulder dislocation. 

Benefits of Movement Post Dislocated Shoulder

There is a delicate balance with post-injury treatment that needs to be found after a shoulder dislocation. Initially, the shoulder will be swollen, sore, and most likely feeling unstable due to overstretching of the joint capsule, muscles, and local ligaments. Thus, some downtime is required to allow restoration of the shoulder’s innate stability, although it will most likely not be as stable as it was before. On the other hand, too much rest can actually have the opposite effect-leading to too much stiffness and increasing your risk of a frozen shoulder.  When the time is right, depending on the severity and whether you had surgery, here are some of the great benefits of shoulder movement.

• Increased circulation to the upper arm to promote healing
• Decreased shoulder pain and swelling
• Reduced risk of excessive stiffness 
• Restoration of strength in the shoulder muscles
• Decrease in shoulder instability 
• Increased confidence in your shoulder
• Quicker to return to previous level of activity 
• Improved quality of life after a shoulder injury

More Ways to Recover from a Dislocated Shoulder

When to Start Exercises

This is dependent on your specific injury and symptoms. Ultimately, with moderate to severe cases it’s important to be cleared by your doctor first before starting any type of exercise. If your shoulder is managed conservatively, you can expect to get started within a few days or weeks once your symptoms have started decreasing.

If you end up needing surgery due to an unstable shoulder, your surgeon will provide a specific protocol to follow based on your shoulder’s specific needs. In general, you can start assisted shoulder range of motion around 3 to 4 weeks postoperatively with the help of a physical therapist (while still wearing the sling most of the day).

• It’s important to avoid overhead reaching and rotation of the shoulder until approximately 6 weeks. After that, it mostly comes down to comfort. 
• Ultimately, avoid anything that feels excessively straining or painful until the shoulder is strong enough, since this will come with time and healing. 

Best Shoulder Dislocation Exercises

Exercises will include passive range of motion and gradual progression to more active and bigger ranges as tissues heal and your pain tolerance improves. Followed by dynamic shoulder strengthening exercises that build muscle and coordination within a functional range of motion. 

1. Shoulder Pendulums

This is the most basic exercise you can do with your shoulder once you are cleared to have your shoulder out of the sling. It is designed to simply get your shoulder used to moving without pain while promoting relaxation and reducing stiffness.

• Take your shoulder sling off
• Let your arm dangle in a relaxed position by your side
• Stand near a chair or counter
• Stand in a small staggered lunge position as you lean forward with your trunk to approximately 45 degrees or more
• Keep your arm relaxed and passively dangled as you start to sway and shift your weight forwards and backwards 
• As you move back and forth, your arm should passively follow the motion of your entire body back and forth
• The key is to keep the shoulder relaxed so that the movement is completely passive and led by your trunk movement
• You can change the positioning of your legs to a wider stance to also shift side to side, or even in a circle
• Repeat for 1-2 minutes with each direction that you can tolerate

Purchasing a cost efficient shoulder pulley is a great rehab tool for any type of shoulder injury. It’s one of the first ways you can safely move your shoulder with minimal pain. You simply use your opposite hand to passively move the bad shoulder. With time, you can gradually progress to a more active range.

• Shut the top of your pulley into a door
• Depending on your height and the door frame- you can stand or place a chair directly underneath the pulley with the back of the chair touching the door 
• Grab one handle with each hand- pointing the palms either down toward the floor or at each other (whichever is more comfortable)
• Keep good posture with your neck relaxed
• Use your good hand to guide the injured shoulder up above your head
• Start with a goal of shoulder height and gradually progress to full range of motion while staying relaxed and relatively pain free 
• Hold for 5-10 seconds at end range before returning to the starting position 
• Repeat 10 times for 2-3 sets

3. Isometric Shoulder Abduction

Isometric exercise is defined as exercise that works a specific muscle group without any actual movement. This is a perfect starting point for a recovering dislocated shoulder, since you can keep local muscles active while still in a sling and allowing appropriate rest time. That way the transition to more active motion will be easier when you’re ready.

• Stand near a wall with the side of your injured arm facing it and touching the wall
• Place a small pillow or folded towel between your elbow and the wall for cushioning
• Push your elbow into the wall as if you’re going to lift your arm straight up to the side
• Press as hard as you can without pain or tension in the neck and hold for 5 seconds
• Repeat 10 times for 2-3 sets
• Additionally, you can turn and face the wall while placing your fist on the wall and push straight forward to strengthen flexion as well
• With time, progress to more active motion with the shoulder

4. Isometric Shoulder Rotation

When the shoulder feels weak and active or full shoulder range of motion is not allowed, once again isometric exercises for rotation are a great starting option. Over time, you can increase your pressure and eventually start using resistance bands when you are cleared to do more with your arm actively. These basic exercises target some of the key rotator cuff muscles.

• Stand or sit in a comfortable position
• Keep your injured arm tucked at your side with your elbow bent to 90 degrees
• If needed, you can tuck a small pillow or towel in between your side and elbow for comfort
• Take your opposite hand and place the palm on the outside of your injured hand to create resistance for external rotation
• With your opposite hand in place, pull on the injured hand as if you are going to pull it across the body toward your belly button (without actually moving the shoulder)
• Hold at a comfortable amount of pressure while keeping the neck relaxed for up to 5 seconds
• Repeat 10 times for 2-3 sets
• Additionally, you can switch directions to address internal rotation as well

Make sure to talk to your sports medicine doctor about any restrictions on muscle use if you've had surgery first. For example, surgery following anterior shoulder dislocation (the most common type) often involves eternal rotation restrictions for the first 4 to 6 weeks.

5. Shoulder Flexion on Hands and Knees

Once you are cleared to increase your shoulder range of motion, there are several different ways outside of using a pulley that you can utilize to stretch the shoulder. This exercise is designed to increase shoulder flexion without having to fully activate the muscles in the arms that could cause pain.

• Get on your hands and knees with the hands directly under the shoulders
• Keeps your palms resting in place on the floor as you shift your butt back toward your heels
• This move inadvertently puts the shoulders into a flexed position- move as far as is comfortable and hold for 10+ seconds
• Repeat for up to 10 repetitions for 2-3 sets
• Progress your range of motion as tolerated by bringing your chest closer to the ground 
• If you are having trouble tolerating this position, you can also try lying on your back with a wand

You can start this exercise without resistance and then gradually progress to use of a band. The strength and coordination of the scapula, or shoulder blade, muscles play an important role in shoulder balance and function. This is a great one to get started with and build from there.

• Stand or sit in good posture- with the shoulders back and head aligned over top of the shoulders rather than slouching forward
• Squeeze the shoulder blades together as if you were going to hold a quarter in the center of your mid-back
• Keep the neck relaxed and shoulders down
• Hold for 5 seconds
• Repeat 10-15 times for 2-3 sets
• To progress, wrap a band around a sturdy surface and hold each end with your hands at your sides

These are all great exercises for getting started in the first few weeks of recovery. Eventually, you will want to progress to more functional movements. This should include full active shoulder range of motion, weighted or resistance based moves (rows, biceps curls, tricep curls, side raises, etc.), and scapular exercises (prone supermans, planks, etc.).

Consult a Physical Therapist

Throughout the entire shoulder recovery process, there is a high chance that you will have questions and feel unsure about what you should be doing. This is where scheduling physical therapy can make a big difference. They can perform an in-depth assessment to help you stay on track and heal with optimal pain relief. Plus, they can help you address any underlying weakness or imbalances that could lead to future shoulder issues or the onset of chronic dislocations. They are your best guide for giving you the confidence for a complete recovery, both conservatively and after undergoing surgery.

Getting Started with Shoulder Exercises

It’s important to start shoulder exercises as soon as your shoulder is ready after a dislocation. This makes for a better road to recovery with fewer complications in the future. The biggest goal is to restore shoulder function with minimal symptoms so that you can get back to your life without any hiccups, whether that’s being able to brush your hair or get back to contact sports.

Talk to your healthcare provider for further medical advice if your symptoms get worse or you experience continual sensations of instability in the shoulder.

References:

https://www.sports-health.com/treatment/shoulder-injury-treatment/recovering-shoulder-dislocation-surgery

https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=zp4512

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