Recurrent shoulder dislocation can lead to increased shoulder joint instability. The capsular or ligamentous support of the shoulder becomes stretched, and over time, muscles that add back-up stability to the joint can become injured. The most common direction of dislocation is the movement of the head of the humerus forward and downward, ahead of normal joint constraints. Strengthening the muscles of the shoulder that oppose this abnormal movement can increase joint stability.
Considerations
If you have had a number of shoulder dislocations, it is important to have your shoulder assessed by a physician. Additional injuries, such as rotator cuff tear, biceps rupture, and cartilage or bony injuries, can occur with dislocation. Exercise can cause more trauma to the joint if these lesions are present.
Warnings
Certain movements and positions can put your shoulder at risk for re-dislocation. If you dislocate frequently, you are likely familiar with what these positions are. For anterior or forward dislocations, avoid extreme positions that look like throwing a ball. If you dislocate posteriorly, avoid positions that rotate your arm inward, such as reaching up behind your back. You should only exercise in these positions once you have achieved excellent joint control and stability.
Anterior Stabilizers: Subscapularis
The subscapularis and the long head of biceps tendon add support to the front of the joint. With repeated or severe dislocations, both of these structures can be torn. Exercise the subscapularis, which is part of the rotator cuff, with inner or internal rotation. You can use tubing, bands or low weights to target this muscle. Standing sideways to your resistance -- with the shoulder you are exercising closest to the weight -- hold your elbow bent and at your side. Pull the weight towards your belly without letting the elbow leave your side. As you release, allow your arm to rotate outward as tolerated.
Anterior Stabilizers: The Long Head of Biceps
The tendon of the long head of biceps crosses the front of the shoulder joint. To strengthen it, use traditional biceps exercises. More specific exercise would involve long arm raises to shoulder height, with a focus on the lowering phase of the exercise. When exercising for stability versus power, focusing on the negative or eccentric portion of an exercise is most effective. Higher repetitions with lower weight are recommended.
Joint Control
Proprioception, or joint awareness, is an important component of stability training for the shoulder. Exercises that challenge the shoulder to react to dynamic challenges can increase joint control. Exercises that work the coordinated effort of your shoulder stabilizers include: balancing in a push-up position over an exercise ball; hands and knees position with hands on an upside-down Bosu cushion; or lying on your back, rapidly tapping an exercise ball between your hands.
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