I. Dislocation of shoulder joint
In addition, sudden excessive dorsiflexion or external rotation of the upper arm in the external booth or a blow to the back of the humeral head can also cause shoulder dislocation. Dislocation of the shoulder is often accompanied by a tear in the labrum of the glenoid, a fracture of the greater tuberosity of the humerus, a fracture of the surgical neck of the humerus, or a large fracture of the scapular glenoid. Some shoulder dislocations can form recurrent dislocations if they are not treated properly.
Treatment of shoulder dislocation
1.Conservative treatment: If there is no serious complication after shoulder dislocation, you can adopt the manual repositioning, kyphosis and foot stirrup method.
2.Surgical treatment: If the shoulder joint dislocation has the following conditions, surgical treatment should be used. Shoulder dislocation combined with nerve or blood vessel injury; those who failed in manual repositioning; combined with humeral surgical neck or humeral greater tuberosity fracture with difficulty in manual repositioning.
3. Shoulder dislocation should be fixed in the forearm in front of the chest for about 3-4 weeks after surgery or conservative treatment by applying triangular towel or elastic band.
C. Post-operative rehabilitation program for shoulder dislocation
1.One week after reset or surgery
Exercise requirements at this stage: exercise without or with slight pain; slightly slow but controlled movements.
(1) Triangular towel suspension for protection and fixation.
(2) Open hand and fist exercise forcefully open palm and hold for 2 seconds, then clench fist to maximum strength, hold for 2 seconds, relax and repeat, awake for 5-10 minutes/hour after anesthesia awakening.
(3) Triceps isometric contraction exercises: isometric contraction exercises for the dorsal muscles of the affected upper arm, can be performed with the assistance and protection of the healthy limb, 30 times/group, 3-4 groups/day.
(4) Shoulder shrugging exercise: shrug the shoulder to the maximum force tolerated, hold for 2 seconds, relax and repeat, 30 times/group, 3-4 groups/day. Also, “chest expansion” and “chest containing” exercises for muscle strength around the shoulder joint.
(5) Active wrist flexion and extension exercises: try to move the wrist joint in a wide range, 30 times/group, 3-4 groups/day.
(6) About three days after surgery: Start shoulder joint “swing exercises” according to the situation. Bend your body forward (bend over) until your upper body is parallel to the ground, and swing your arm under the protection of a triangular scarf and the hand on your healthy side. Start with anterior-posterior direction, and after getting used to the basic painlessness, add lateral left and right direction, and finally add circular movements, gradually increasing the range of motion, but not exceeding 90°, 20-30 times/group in each direction, 1-2 groups/day, and apply ice for 15-20 minutes immediately after the exercise.
(7) Postoperative week 2-3: Continue and strengthen the above exercises, gradually increase the load and the angle of passive activities.
2.Weeks 4-6 after surgery
(1) Continue and strengthen the above exercises, among which exercises that are completely painless and without fatigue can no longer be performed.
(2) Biceps isometric exercises can be performed with the assistance and protection of the healthy limb, 30 times/group, 3-4 groups/day.
3.Postoperative period from 7th to 3rd month
The main purpose of this stage is to gradually restore joint mobility. Exercises should be performed with full relaxation of the affected limb, without or with minimal pain, gently and slowly, and without violence.
(1) Try to remove the protection of the triangular scarf from 6-7 weeks after surgery.
(2) Active shoulder joint strength exercises.
Front planks: raise the arm in front of the body to a pain-free angle without shrugging the shoulder! Hold in the highest position for 2 minutes, rest for 5 seconds, 5 consecutive sets, 2-3 sets/day. Straighten the arm after the strength is increased.
Side planks: Raise the arm to a pain-free angle on the side of the body without shrugging the shoulders! Hold in the highest position for 2 minutes, rest for 5 seconds, and perform 5 consecutive sets of 2-3 sets/day. Perform with straightened arms after strength building.