A posterior shoulder dislocation is a traumatic injury to the shoulder. In a healthy, uninjured shoulder, the upper arm, or humerus, sits in a shallow bowl, much like a golf ball sits on a tee. When a dislocation occurs, the upper arm pops out of the shallow bowl. The posterior dislocation, when the shoulder pops out backward, is rare. According to Daniel Arnheim in the book "Modern Principles of Athletic Training," posterior dislocations make up 1 percent to 4.3 percent of all shoulder dislocations. The injury is accompanied by an audible pop and extreme pain. The injury causes damage to muscles and ligaments around the joint.
Early Stage Exercises
Following a posterior shoulder dislocation, the joint is typically immobilized for up to six weeks. This allows the tissue to heal. Once removed from immobilization, the injured person should begin light range of motion exercises and stretching. The first exercises to begin are Codman's exercises. Lie face down on the edge of the table and have the injured arm hang off the edge toward the floor. With the arm hanging down perform small clockwise and counterclockwise circles. A light weight --- 1 to 2 lbs. --- can be held for increased pull.
Internal Rotator Cuff Stretching
Stretching should begin once cleared to do so by the treating physician. For these stretches, use a light bat or broom handle. Begin by lying flat on the back. Keep the upper arms flat on the table and bend at the elbows. Grasp the broom handle with both bands. With the uninjured arm push the broom handle across the body. This will cause the injured arm to rotate outward. Go until a slight stretch is felt in the injured side and hold for 20 to 30 seconds.
External Rotator Cuff Stretching
Again use a light weight bat or broom stick. Begin by lying flat on the back. Keep the upper arms flat on the table and bend both arms at the elbows. Grasp the broom handle with both hands. Next have the uninjured arm pull the broom stick across the body. Keep the injured arm relaxed. Pulling with the uninjured arm will cause the injured arm to come across the body. Once a slight stretch is felt, hold the position for 20 to 30 seconds.
Isometric Strengthening
William Prentice in "Rehabilitation Techniques in Sports Medicine" states that strengthening should begin six to 12 weeks after the patient is removed from immobilization. The initial strengthening exercises done should be isometric exercises. Stand next to a wall so that the injured side is closest to the wall. Bend the injured arm at the elbow to 90 degrees. While keeping the upper firm against the side of the body, rotate the shoulder so that the hand pushes against the wall. Push the hand against the wall for five seconds. Repeat this motion five times.
References
- "Modern Principles of Athletic Training 7th Edition"; Daniel Arnheim; 1989
- "Rehabilitation Techniques in Sports Medicine, Third Edition"; William E. Prentice; 1999
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