Conservative Management of Recurrent Shoulder Dislocation
The glenohumeral ball-and-socket joint of the shoulder is by nature shallow, which affords it the widest range of motion (ROM) of any joint in the human body. But its design also makes it the most unstable, exposing it to subluxations and dislocations from both nontraumatic and traumatic incidents.
This paper examines the role of conservative management in recurrent shoulder dislocations.
It explains that conservative management is the best option in cases where surgery is contraindicated or in which surgery did not provide a satisfactory outcome. The paper also addresses common clinical issues, such as the controversy over the value of immobilization versus immediate rehabilitation.
The author provides sufficient detail and step-by-step explanations and examples to help guide practitioners in making clinical choices regarding shoulder dislocations. He points out that the earlier a first-time dislocation occurs (under 30 years of age), the greater the likelihood of increased rate of recurrence. And he reminds readers that the lower the level of trauma causing the initial dislocation, the greater the instability of the joint and the increased rate of recurrence.
The author explains why conservative management and rehabilitation efforts can be enormously successful: "Because anterior instability is believed to account for 95% of shoulder instability as a whole, strengthening the supportive structures anterior to the glenohumeral joint can reduce the tendency for recurrent anterior/inferior subluxation or dislocation of the humeral head."
This paper provides helpful information; however, several recent studies on conservative management of shoulder dislocations were not included in this review.
Perman SM. Conservative management of recurrent anterior dislocation of the shoulder. Journal of Sports Chiropractic & Rehabilitation, 1999; 13(1), pp28-31.