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Physiotherapy for Shoulder Dislocation

Shoulder dislocation is one of the most common joint injuries, particularly among active individuals. At Blue Space Physiotherapy, we see patient with both history of subluxations, dislocation, and after shoulder dislocation surgery.

In this article, we will talk about non-surgical shoulder dislocations and physical therapy.

What Is a Shoulder Dislocation?

Shoulder X- Ray- Informative for Shoulder Dislocation Physiotherapy
Shoulder X-Ray. Note how the shoulder is nice and even in its socket.
Shoulder Dislocation X- Ray- Informative for Shoulder Dislocation Physiotherapy
Shoulder Dislocation X- Ray. Note how the shoulder is out of its socket.

A shoulder dislocation occurs when the upper arm bone (humerus) comes out of its normal position in the socket (glenoid) of the shoulder blade. Due to its wide range of motion and relatively shallow socket, the shoulder joint is more prone to dislocation than any other joint in the body.

In fact, nearly half of all major joint dislocations involve the shoulder. The most common type is an anterior dislocation, which accounts for about 95% of shoulder dislocation cases.

 

Anterior Shoulder Dislocation

Anterior shoulder dislocations usually happen when the arm is forcibly rotated outward (external rotation) and lifted away from the body (abduction). Usually this happens during sports, falls, or other traumatic mechanisms.

This position puts strain on the front of the shoulder joint, often damaging the ligaments, labrum, and sometimes nearby nerves or blood vessels.

Common associated injuries with anterior dislocations include:

  • Bankart lesions – tears to the front portion of the labrum
  • Hill-Sachs lesions – bone damage on the head of the humerus
  • Instability in the joint due to ligament injury

These complications may contribute to long-term instability or repeated dislocations if not treated effectively.

Treatment and Physical Therapy Plan

After a shoulder dislocation, it is absolutely essential to follow a structured physical therapy plan to restore strength, mobility, and joint stability. It’s essential that you complete the full course of physical therapy in order to ensure that you have a stable, pain-free shoulder.

At Blue Space Physiotherapy, we will guide you through each stage of your recovery with personalized care.

Immediate Care and Reduction

The dislocated joint should be repositioned (reduced) by a medical professional as soon as possible. Usually this is done by an orthopedic surgeon or an emergency physician. This is usually done in an emergency setting, followed by immobilization in a sling.

Physiotherapy Phases for Shoulder Dislocation

Phase 1: Immobilization and Early Recovery (0–6 Weeks)

  • During this phase, the goal is to protect the joint, reduce pain, and begin gentle activation of surrounding muscles.
  • Sling immobilization (typically 2-4 weeks)
  • Focus on pain management and inflammation control
  • Begin range-of-motion (ROM) exercises for the elbow, wrist, and hand
  • Gentle isometric strengthening for the shoulder (e.g., Codman’s exercises)
  • Passive or assisted ROM for external rotation and forward elevation may begin cautiously
  • Some studies suggest that immobilization with the shoulder in slight external rotation may reduce recurrence compared to traditional internal rotation slings.

Phase 2: Regaining Range of Motion (6–12 Weeks)

  • As pain and swelling decrease, therapy shifts toward restoring shoulder mobility and flexibility.
  • Active-assisted ROM to increase external rotation and abduction
  • Gentle posterior capsule stretching through manual therapy or self-mobilization
  • The goal is to safely regain full range of movement without stressing healing tissues.

Phase 3: Strengthening and Functional Training (12–24 Weeks)

  • Once motion is restored, rehabilitation progresses to strengthening and functional movements tailored to your lifestyle or sport.
  • Begin strengthening exercises for the rotator cuff and scapular stabilizers
  • Add proprioception and balance training for shoulder stability
  • Progression to compound and sport-specific movements
  • Build endurance and control through functional exercises

End Goal:

For your to return to your normal lifestyle without any risk for FUTURE dislocations, with a strong and pain-free shoulder

What to expect with shoulder dislocation Physiotherapy

Our Approach

Our physical therapy approach is grounded in evidence-based care. Each patient is evaluated based on their medical history, deficits due to the dislocation, and overall mobility and restrictions. 

Overall physical therapy involves participation of patients, and frequently, caregivers, in in-clinic and at-home exercises, and sensory and motor re-learning.

Your physical plan is informed by clinical evaluation and patient priorities.

Each plan is designed to improve confidence and reduce the risk of future dislocations.

How long will it take?
Most shoulder dislocations require 4-6 months of physical therapy.

Be prepared to work through plateaus
Your recovery may slow down or seem to stop for a time. You may even feel you are getting worse. This is a common feeling. Your therapist may say you have reached a plateau and may reassess your abilities. Don’t get discouraged.

You will likely find that you keep making progress for many months!

In Summary

Shoulder Dislocations are a difficult injury to navigate. Physical therapy is a primary modality in returning to function after a shoulder dislocation.

If you have any questions or need to see us, please get in touch!

About the author

Arjun Patel, PT, MScPT, MCPA is an orthopedic, neuro, and vestibular physiotherapist. He is the director of Blue Space Clinic Physiotherapy and sees complex cases on a daily basis. He is also an adjunct lecturer at the faculty of medicine at University of Toronto.

To learn more about Arjun and our clinic, click here!

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