Primary Shoulder Dislocation

NHS Virtual Fracture Clinic - Shoulder Dislocation 

About your injury:

After a dislocation there is increased risk of dislocating the shoulder again. This depends on your age and other factors. If your shoulder dislocates again A&E will refer you to our team for Specialist review. 

Healing:

It takes approximately 6 weeks for the soft tissues to settle. 

 

Pain and swelling:

Your shoulder may be swollen and you will have some pain. Taking pain medication and using ice or cold packs will help. More information is below. 

You may have a small patch of numbness on the outside of the shoulder. This will improve with time. Please contact us if you have any of the following symptoms. 

• Pins and needles or numbness of the arm or in your hand
• If you are struggling to move the hand or arm at all 
• You have pain or symptoms anywhere other than your shoulder 

Wearing your sling: 

Use your sling for 1 weeks only, including in bed at night. Yo

u can take it off to wash, dress and do your exercises.

 

Exercise and activity:

It is important to start gentle exercises straight away to prevent stiffness. You will find pictures and instructions for your exercises below. 

You should not lift the arm over shoulder height for 3 weeks or do heavy lifting for 6 weeks.

Follow up:

We do not routinely follow up patients with this injury in an orthopaedic clinic. We will make an urgent referral to physiotherapy for you to help with your rehabilitation. If your physiotherapist has any concerns about your progress, they will refer you back to clinic. 

Contact us:

If you are concerned about your symptoms, are unable to follow this rehabilitation plan or have pain other than at the site of your injury please contact the Virtual Fracture Clinic team.

Caring for your injury: Weeks 1-3

Wear your sling for the first week only, including in bed at night. You may find it more comfortable to sleep propped up on pillows. Remove the sling for washing, dressing and exercises. 

Using a cold pack will help with your pain and swelling. You can use an ice pack or bag of frozen peas wrapped in a damp towel. Put this on your foot for up to 15 minutes every few hours. Make sure the ice is not in direct contact with your skin.

Try to rest your arm, especially in the first 24-72 hours. Remember to avoid overhead activity and heavy lifting. 

Exercises:

Start these exercises straight away. Hand, wrist and elbow exercises are only needed a while you are wearing a sling. You can stop these once they become easy and you have full movement. Try to do these exercises 4-5 times a day. Repeat each exercise 10 times. 

Hand, wrist and elbow exercises:

1. Open and close your hand. Next, move your wrist up and down. Repeat 10 times. 2. After a few days, hold a soft ball or rolled up socks. Squeeze the ball and hold for 5 seconds. Repeat 5 times.
3. Bend and straighten your elbow. Repeat 10 times.  4. Bend your elbow to a right angle. Slowly turn your palm up to the ceiling and down to the ground. Repeat 10 times.

 

Posture Exercise: 

1. Bring your shoulders back and gently squeeze your shoulder blades together. Hold for 20-30 seconds. Repeat 5 times.

 

Shoulder Pendulum Exercise: 

 

1. Stand next to a firm surface. Support yourself with your un-injured arm and lean forwards. Let your injured arm relax and hang down to the ground.  2. Gently swing your arm, making a small movement. Try to do this forward and backward, side to side and in small circles.  3. Aim to do this for 1-2 minutes in total. You do not need to push into pain. Remember to keep your arm relaxed.

 

Caring for your injury: Weeks 3-6

You can now return to light activities. Remember, you should not do any heavy lifting for 6 weeks. 

Exercises:

Start these exercises 3 weeks after your injury. Try to do them 4-5 times a day. Repeat each exercise 10 times. 

 

Active Assisted Flexion 1. Use your other hand to lift your injured arm up in front of you, as shown in these pictures.
Active Assisted External Rotation  2. Keep the elbow of your injured arm tucked into your side and your elbow bent. Hold onto a stick, umbrella or something similar.  3. Use your good arm to push your injured hand outwards. Remember to keep your elbow tucked in.  4. If you don't have a stick, hold your injured arm at the wrist, guide it outwards with your good hand.

 

Caring for your injury: Weeks 6-12

You can now return to light activities. Do this gradually and be guided by any pain or discomfort your experience. Some heavier tasks may still be uncomfortable. 

Exercises: 

Start these exercises 6 weeks after your injury. Try to do these exercises 4-5 times a day. Repeat each exercise 10 times. 

Active Flexion: 

Lift your arm forwards in front of you. Try to raise the arm as high as you can. You do not need to push into pain. If this is too difficult, try the same movement with a bent elbow. 

 

 

Active Abduction:

With your palm facing forwards, move your arm out to the side in a big arc. Try to raise the arm as high as you can. You do not need to push into pain If this is too difficult, try the same movement with a bent elbow. 

 

 

Active External Rotation

Start with your elbow bent by your side. Move your forearm out to the side, keeping your elbow bent and near your waist.

 

 

Frequently asked questions