Strengthening exercises which may form part of a dislocated shoulder rehabilitation program.
A strengthening program for an anterior dislocated shoulder can begin as soon as pain allows. It is important for the athlete to avoid any movements which abduct and laterally rotate the shoulder in the early stages as this is the position the shoulder is most likely to dislocate again. Initially static exercises involving no movement should be done and progressed gradually.
Isometric shoulder exercises
Isometric means without movement, also known as static contractions. These are exercises where the muscles are being worked without moving the joint, and are often quite useful if the joint itself is still healing.
Isometric extension - Standing with your back against a wall, with your arms by your side. While keeping your elbows and wrists straight, push back into the wall and hold for 5 seconds. Work to increase this to 10 seconds. Repeat this 5 times.
To do the same for isometric flexion face the wall and use it as resistance in the same way as for extension exercises.
Isometric adduction - With a small pillow or a rolled up newspaper between your injured arm and your torso, squeeze inwards and try to hold it in position. Start with a small item and gradually move to larger sizes to work through a larger range of movement. Hold for 5 seconds (work to increase to 10). Repeat this 5 times (work to increase to 10).
Isometric Abduction - Stand side-on to a wall, with the arm to be worked next to it. Place the back of the wrist against the wall and push outwards as if trying to raise the arm to the side. Hold for 5 seconds (work to increase to 10). Repeat this 5 times (work to increase to 10).
External Rotation - Stand facing a door frame. Keep the elbow bent to 90 degrees and place the back of the hand against the frame. Push against the it. Hold for 5 seconds (work to increase to 10) and repeat 5 times (work to increase to 10).
Internal Rotation - Stand facing a door frame. Bend the elbow to 90 degrees, and place the palm of the hand on the side of the door frame and push against it. Hold for 5 seconds (work to increase to 10) and repeat 5 times (work to increase to 10).
Play isometric shoulder exercises video.
This is the most important exercise as it strengthens the muscles which help prevent an anterior shoulder dislocation. Three of the five muscles which medially or internally rotate the shoulder are the pectoralis major, subscapularis and latissimus dorsi. In the early stages it is important to keep the shoulder joint in the inner range of motion. This means working from the position where the hand is out in front so it works across the body. Taking the shoulder into the outer range of motion puts it at risk of dislocation.
Play internal shoulder rotation exercise video.
This exercise works the muscle which externally rotate the shoulder. It can be done with a resistance band or a dumbelle. This exercise should be avoided in the very early stages. When the shoulder has healed enough to begin external rotation exercises it is important to remain within the internal range of movement until told otherwise by your therapist.
Externally rotating the shoulder before it is ready puts it at risk of dislocation. Wrap the resistance band around something stable and hold the other end standing so that the band crosses the body. Keeping the elbow bent to 90 degrees and the upper arm by the side, rotate the shoulder to pull the band away from the body.
Play external rotation with dumbelle exercise video.
Stand on one end of the band and hold the other end. Keeping the elbow straight, pull your arm out to the side so that the hand ends up level with your shoulder.
Stand on the band holding the other end in the hand of your injured arm. Keeping the elbow straight, pull your hand straight up in front of you to about shoulder height. Once the athlete is comfortable with the exercises above, the resistance band can be replaced with weights to progress the strengthening exercises described above.
Wrap the band around something secure, hold the other end and stand with your injured side closest to the attachment. Keeping the elbow straight, pull your hand across your body as far as is comfortable.
Stand on the center of the band and hold the ends in either hand. Start with the elbows bent and hands at shoulder height. From there, straighten your arms and push up above your head. Slowly return to the starting position and repeat. Many of these exercises can also be performed with free weights as your strength progresses.