Secondary Injuries from Shoulder Dislocations

With a noticeable increase in shoulder injuries being treated at our clinic, there is a growing interest in understanding common secondary shoulder injuries. These injuries often occur as a result of shoulder dislocations and can have a significant impact on one’s daily activities and overall quality of life. In this blog, we will delve into some common secondary shoulder injuries, providing insights and guidance for those seeking to understand these conditions and their implications.

Secondary injuries:

  • Bankart Lesions are one of the most common secondary injuries observed after shoulder dislocations. These injuries involve tears or detachment of the labrum, the fibrocartilaginous ring that surrounds the glenoid socket and enhances its stability. Bankart lesions can compromise the shoulder’s ability to maintain proper joint alignment and increase the risk of recurrent dislocations.
  • Hill-Sachs Lesions are another frequently encountered secondary injury. They occur when the impact of the dislocated humeral head against the glenoid socket causes compression fractures or indentations. These lesions can weaken the structural integrity of the humeral head, potentially leading to instability and recurrent dislocations.
  • Rotator Cuff Pathology/Tears are also prevalent secondary injuries following shoulder dislocations. The rotator cuff consists of a group of muscles and tendons that support and control the movement of the shoulder joint. The dislocation event can subject the rotator cuff tendons to significant stress, resulting in partial or complete tears. These tears can impair shoulder function, weaken the joint, and contribute to instability.
  • Labral Tears/Irritation are frequently associated with shoulder dislocations. The labrum is a ring of cartilage that deepens the glenoid socket, providing stability to the shoulder joint. Dislocations can cause labral tears, which further compromise joint stability and increase the risk of future dislocations.
  • Glenohumeral Ligament Sprains can also occur as secondary injuries after shoulder dislocations. These ligaments play a crucial role in maintaining the stability of the shoulder joint. Dislocations can stretch or damage these ligaments, leading to instability and diminished joint support.

These common secondary injuries highlight the complexity and potential complications that arise after a shoulder dislocation. Addressing these injuries in rehabilitation is crucial for restoring stability, function, and preventing recurrent dislocations.

Rehabilitation following a shoulder dislocation must address both the primary injury and any accompanying secondary injuries to achieve optimal recovery. Physiotherapy plays a crucial role in the rehabilitation process by focusing on restoring strength, range of motion, and stability while considering the specific secondary injuries present.

Rehabilitation strategies for each secondary injury may vary but typically involve a combination of targeted exercises, manual therapy, and functional training. For Bankart and Hill-Sachs lesions, exercises aim to strengthen the surrounding muscles, improve shoulder stability, and restore range of motion. Exercises may include rotator cuff strengthening, scapular stabilization, and range of motion exercises, tailored to the individual’s condition.

For rotator cuff tears and labral tears, physiotherapy emphasizes progressive exercises to gradually strengthen the affected muscles and promote proper shoulder mechanics. Manual therapy techniques, such as joint mobilizations and soft tissue massage, may also be employed to aid healing and reduce pain.

Glenohumeral ligament sprains require stability exercises and proprioceptive training to restore ligament integrity and enhance joint stability. Physiotherapists may incorporate exercises that challenge balance and coordination while gradually increasing the demands on the shoulder joint.

Secondary injuries often accompany shoulder dislocations, requiring specific attention during rehabilitation. Physiotherapy is instrumental in addressing these injuries, providing targeted exercises and therapies to restore strength, range of motion, and stability. A comprehensive rehabilitation program, tailored to the individual’s needs, is crucial for achieving optimal recovery from shoulder dislocations and their associated secondary injuries.

References:

Gupta A, Delaney R, Petkin K, Lafosse L. Hill-Sachs Lesions: Current Concepts. EFORT Open Rev. 2017;2(5):195-204. doi:10.1302/2058-5241.2.160057

Hovelius L, Olofsson A, Sandström B, Augustini BG, Krantz L, Fredin H. Rehabilitation Following Anterior Shoulder Dislocation: A Prospective Randomized Trial of Immobilization Compared to Early Motion. J Bone Joint Surg Am. 2008;90(11):2313-2321. doi:10.2106/JBJS.G.00003

Makhni EC, Swart E, Steinhaus ME, et al. Bankart Repair for Anterior Shoulder Instability: A Systematic Review. Am J Sports Med. 2014;42(11):2511-2518. doi:10.1177/0363546513497915

Moroder P, Hufeland M, Ciritsis B, et al. Labral Tears and Instability of the Shoulder Joint. EFORT Open Rev. 2017;2(5):201-209. doi:10.1302/2058-5241.2.160060

Schneeberger AG, Nyffeler RW, Gerber C. Treatment of Rotator Cuff Tears. Dtsch Arztebl Int. 2016;113(51-52):875-882. doi:10.3238/arztebl.2016.0875

Jamie Cheok – BeFit Training Physio Coogee

Jamie Cheok – BeFit Training Physio Coogee

Jamie Cheok is a physiotherapist based in Coogee in the Eastern Suburbs of Sydney. Jamie has successfully treated musculoskeletal problems on the basis of a thorough assessment and diagnosis coupled with evidence-based rehabilitation programs tailored to the needs and goals of each individual. To book a consultation, click the link below.

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