HOW IS SHOULDER INSTABILITY INITIALLY TREATED?

After a shoulder has dislocated  it is important to rest it and avoid aggravating activities for a couple of days. If the pain is significant, such as  following a traumatic dislocation, a sling is used. Once the pain and swelling have subsided, range of motion exercises are started. Strengthening exercises are begun as motion improves.

Typically, the exercise program is done in conjunction with a  physiotherapist. Applying cold packs or ice bags to the shoulder before and after exercise can help reduce the pain and swelling. NSAIDS (non steroidal anti-inflammatory drugs),  can be used to reduce pain and swelling. You should check with your doctor because a number of different kinds of  drugs are available. They may have side effects and if you have questions you should consult your doctor.

The goal of therapy is to restore shoulder motion and increase the strength of the muscles around shoulder. Strong muscles, especially those of the rotator cuff,  may help to protect and help prevent the shoulder from re-dislocating or subluxing. Once full function of the shoulder has returned, you may can gradually return to activities.

The risk of ongoing instability  depends largely on:

• Your age- if you are under the age of 20 at initial dislocation the chance of recurrent dislocation is almost 100%. By the age of 40 years old the chances are quite slim. However as you grow older the chance of associated injures such as rotator cuff tendon tears or fracture increase.

• How traumatic the first dislocation was- if a large tear to the cartilage or tear of the ligaments occurred, recurrent instability is more common.

• Activates you return to- if you play a high risk sport you are more likely to dislocate.

What you do in the first few weeks after the dislocation does not seem to be a big factor in your chances of re-dislocation.

For young individuals, say under 25 years old with a traumatic dislocation, arthroscopic reconstruction may be considered even after a first dislocation, to prevent a recurrence of the dislocation. A re-dislocation while surfing, parachuting or hang-gliding can be very dangerous.

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