A shoulder luxation is usually caused by a hard fall and is often accompanied by pain and inability to move. Shoulder luxation can be diagnosed by X-ray examination. When the shoulder head is dislocated, it is important that it be repositioned to its original position soon. After the shoulder is repositioned, a rehabilitation process follows under the supervision of a physical therapist. The physiotherapists of Fysiofitaal Tilburg work together with you towards a successful recovery!
Cause:
The shoulder consists of, among other things, a head and a socket. Unlike the hip, for example, the shoulder head is a lot larger than the shoulder socket. This allows for great mobility of the joint, but at the expense of stability. The labrum (a cartilage ring), muscles and ligaments around the shoulder have the job of still providing the necessary stability to keep the shoulder head neatly in its socket. This is usually caused by a hard fall with an outstretched arm. The forces that must be absorbed are then too great, causing the shoulder head to dislocate. Usually forward, this is in 95% of all cases. The shoulder head then comes to sit in front of the socket. The labrum in the shoulder slightly enlarges the socket so it still provides some protection. When your shoulder has really been dislocated, it is possible that the labrum, together with the shoulder capsule, has also suffered a serious blow.
Symptoms:
A shoulder luxation is often accompanied by severe pain. This makes it almost impossible to move the shoulder. As a reflex, the shoulder muscles can tighten violently to stabilize the shoulder as much as possible. Due to the shifting of the shoulder head, a depression in the shoulder can be seen and sometimes the head can be clearly felt at the front of the shoulder.
Diagnosis:
If acute shoulder luxation is suspected, the general practitioner requests an X-ray. This shows to which side the shoulder has shifted and whether other structures have been damaged. Thus, such as the labrum, capsule and tendon tissue.
If you have experienced shoulder luxation in the past, we speak of chronic instability. Here you can experience fear of the shoulder head dislocating. If the shoulder luxates regularly, further examination can be done using an MRI scan and an X-ray. The physiotherapists at Fysiofitaal Tilburg can determine whether there is instability in the shoulder joint by means of a so-called pathology-specific test.
Chronic instability
Chronic instability can have several causes including hypermobility (more mobility in joints than normal). Hypermobility can allow for more mobility in ligaments and joints, thus giving less stability to the head of the shoulder. Therefore, this can cause a luxation to occur more quickly because the shoulder head has more room to move.
It is easy to test for hypermobility.The physiotherapists at Fysiofitaal Tilburg can determine if hypermobility is present through a cluster of physical tests.
However, chronic instability can also result from regular luxation of the shoulder. If this is the case, it is sometimes necessary to use surgery to ensure that the head of the shoulder becomes more stable by securing certain ligaments in the shoulder.
Treatment:
If you have an acute shoulder luxation, it is important that the shoulder head first be returned to its original position (reponate). Depending on the situation, muscle relaxant and/or pain relieving medication may be used. After the shoulder has been repositioned you will wear a sling for two to four weeks after which you will start a rehabilitation program. During the rehabilitation program it is important to increase muscle strength and stability in the shoulder to prevent a new luxation. Exactly how long the rehabilitation will take is difficult to say in advance. It depends on several factors. Physical therapy is advised for 4 to 12 weeks for uncomplicated luxations. An exercise program under the supervision of a physical therapist can also help with chronic instability. The physiotherapists at Fysiofitaal Tilburg offer you professional guidance during your rehabilitation and work together with you towards a successful recovery!
