Shoulder dislocation

SHOULDER DISLOCATION

A shoulder dislocation is an injury where the ball of the upper arm bone (humerus) comes partially or completely out of the socket (glenoid), disrupting the normal ball-and-socket alignment of the joint. It is one of the most common joint dislocations, usually occurring after a fall, sports injury or forceful arm movement into abduction and external rotation, and in most cases it is an anterior dislocation.
People typically experience sudden severe pain, inability to move the shoulder and visible deformity, and urgent medical care is needed to reduce the joint safely. After reduction, pain and weakness can persist for some time and some individuals develop shoulder instability with a tendency for recurrent dislocations, which makes structured physiotherapy an important part of recovery.

What happens inside the joint

The shoulder is the most mobile joint in the body, which also makes it particularly prone to dislocation. In a shoulder dislocation, the humeral head comes out of the glenoid socket (partially in a subluxation or completely in a full dislocation), most often in an anterior direction, and structures such as the labrum, capsule, ligaments and rotator cuff can be injured. People usually present with severe pain, a feeling that the shoulder is “out of place”, inability to move the arm and an altered contour of the shoulder. Initial management takes place in a medical setting where the joint is reduced and the arm is often supported in a sling or brace for a period that varies according to age, injury pattern and associated damage.

After the acute phase, the focus shifts to gradually restoring motion, strength and stability while reducing the risk of recurrence. A physiotherapy programme typically works on controlled range-of-motion exercises, strengthening of the rotator cuff and scapular stabilizers and progressive functional tasks tailored to the person’s daily and sporting demands. Individuals with recurrent dislocations may require more specialised management and, in consultation with an orthopaedic specialist, assessment for possible surgical stabilisation.

From immobilisation to strengthening

After a shoulder dislocation, physiotherapy is crucial to restore joint stability and function and to reduce the risk of further episodes. Once the initial medical management and immobilisation period are completed, the physiotherapist assesses range of motion, pain, feelings of instability and scapular and trunk control. Early rehabilitation focuses on gentle, controlled movements within safe limits, gradual muscle activation and protection of healing tissues.

Later phases introduce progressive strengthening of the rotator cuff and scapular stabilisers, proprioceptive and neuromuscular control drills and functional tasks mirroring work or sporting demands. Education about avoiding high-risk positions in the early stages, a carefully graded return to load and close communication with the medical team, particularly in cases of chronic instability, are key to a safer return to daily activities and sport with fewer recurrences.