Among our relatively minor health disorders which in fact are quite monotonous and exhaustive, there is shoulder subluxation. Subluxations disrupt the normal functioning of the joint. They lead to painful symptoms and the limitation of motion of the corresponding parts of the body. The limitation of motion is usually subacute, with a vague clinical picture. The painful feelings are not intense but a patient is unable to make certain movements. People often think of this state as of a norm and attribute the limited motion to the reasons like a numb limb or drafts and hypothermia, etc.
Such a superficial approach to the problem of subluxations is caused by several reasons:
- a person may be unaware of the subluxation of the shoulder;
- a person misunderstands and ignores the harmful effects of a long-term subluxation;
- a person is ready to accept minor violations just to avoid visiting a doctor;
- a person assures oneself that the problem will disappear on its own;
- unwillingness to deal with a small problem which, in the opinion of many people, is not worth attention.
The reasons mentioned above apply to the majority of people though in each separate case one or several factors prevail. That is why doctors often have to deal with the neglected cases which are the cause of significant circulatory disturbances and nerve conduction in the subluxation area. The abovementioned factors show the importance of a timely diagnosis and subluxation reduction.
What is Shoulder Subluxation?
The definition of the phenomenon is quite simple while the problem is quite serious. Subluxation is a state of a shoulder joint in which the joint surfaces move away from each other but keep the point of contact. Subluxation is characterized by disruption of the normal functioning of the entire joint. It is diagnosed with X-ray and computed tomography. Today, the term “subluxation” is used to denote partial dislocation to avoid confusion. Complete shoulder dislocation is characterized by a shift of the jointed surfaces with the absence of common points between them. Dislocation is accompanied by a serious functional disorder of the area.
Causes of Shoulder Subluxation
The upper limbs are prone to subluxations because of their activity. Like dislocation, shoulder subluxation may be of three types: inferior, posterior, and anterior shoulder subluxation. The causes of shoulder subluxation are divided into two categories:
1. Traumatic shoulder subluxation causes
The traumatic nature of subluxation is caused by the application of force exceeding the normal capacity of the joint. The shoulder joint has a particular anatomical structure which provides a high mobility. Wide amplitude movements reaching the physiological norm (waftures, hand rotations) and falling onto the arm are often the cause of subluxations.
2. Dystrophic causes
The dystrophic causes of shoulder subluxations are brought about by various pathologies. These include: polyarthritis, gout, arthritis, hyperextensible connective tissue, etc. These diseases lead to the disruption of the normal anatomy of the joint by weakening the fixation of the condyles in the capsule. A preceding shoulder dislocation often leads to sprain of muscular-ligamentous apparatus which, therefore, fails to provide a reliable joint fixation and leads to chronic subluxations. Hyperextension of the muscular-ligamentous apparatus is typical of the athletes (swimmers, basketball players).
Shoulder Subluxation Symptoms
Shoulder subluxation symptoms are very subjective. The patients usually feel like the condyles pop out and the structures are out of place. Often subluxation is accompanied by severe pain and the disorder of normal mobility of the upper limb.
The signs of joint subluxations are as follows:
- sharp, piercing, splitting pain in the area of the damaged joint;
- change of the normal form and appearance of the joint;
- swelling and redness with a sensation of fever inside the spot;
- limitation of motion in the affected joint.
If you feel sharp pain in the joint while moving your arm, you should immediately stop the physical activity. Immobilize the arm by strapping it to the chest. Regularly apply a cold compress to the damaged place. Get examined by a specialist as soon as possible in the event of damage. Do not reduce a subluxation on your own.
Shoulder Subluxation Treatment
The proper shoulder subluxation treatment consists of three steps:
- first aid;
- reducing the subluxation;
- support measures aimed at the rehabilitation after subluxation.
This sequence relates to the treatment of subluxations of different severity and complexity. Let us consider each step of the assistance with subluxation.
A patient should receive the first aid immediately after the occurrence of subluxation. That will help to mitigate the effects of the injury as much as possible and provide proper further reduction of subluxation by a specialist.
First of all, it is necessary to completely immobilize the damaged joint with the help of a splint or any means that are available: clothes, scarf, blanket, and straight object of elongated shape (a stick, a rod, a tool handle, etc.). When the joint is immobilized, apply a cold pack to the damaged area. You may use ice in a plastic bag, ice water in a rubber hot-water bottle, or a cloth soaked in cold water.
The injured person must be delivered to a specialized medical institution for the subluxation reduction and discussing of the subsequent rehab measures. Only a qualified specialist should reduce the subluxation (a traumatologists, a chiropractor). Do not try to deal with the problem on your own because a wrong technique of subluxation reduction can lead to a complete dislocation, ligament tear or other more serious damages. You may only reduce a subluxation if there are no complications: fractures or tissue fractures, torn ligaments, etc. One should reduce the subluxation as soon as possible because the swelling and soreness in the periarticular area will grow and complicate any procedures.
In some cases, subluxation may lead to the damage of the surrounding tissues, disruption of the normal structure and dysfunction of an entire body part. In this case, the reduction of subluxation or dislocation is a difficult task, especially if a surgery is necessary. After subluxation reduction there have to be certain measures aimed at full restoration of the damaged joint structure and its functions. The duration of the support measures for the rehabilitation of subluxation may vary and depend on the severity of the injury. The rehabilitation usually includes brace support of the damaged arm, massage, medicines (vitamins, analgesic, regenerating agents), and physiotherapy. The patient after subluxation reduction needs to avoid physical activity and gradually return to the normal use of the joint. The exercises used to treat the damaged joint should be also done even after the rehab period ends. That will strengthen the muscles and ligaments and prevent recurrence of subluxation.
After the doctors take care of the damaged arm, you need to limit the movement of the joint within 1-1.5 months. In general, the treatment for a damaged joint is aimed at pain relief with pills or injections, as well as the restriction of movement and production of correct movement patterns. The therapeutic exercises are necessary for the complete recovery and are aimed at strengthening the muscles which fix the joint properly, preventing the problem recurrences.
Shoulder Subluxation Exercises
It goes without saying that it is better to consult a specialist before you start doing any shoulder subluxation exercises. A doctor will set a special program for you. If you have a medical approval, you may do the following exercises for shoulder subluxation but remember to stop if you feel pain:
- Flexion of the insured shoulder: stand straight with your arms by your sides, keep the elbows straight. Try to lift your arm as high as it is possible and hold it for 5 seconds. Repeat the exercise 10 times.
- Extension of the shoulder: stand straight with your arms by your sides and keep your elbows straight. Try to move one arm backwards as much as you can but don’t force the arm (5 seconds, 10 times). Repeat the exercise with the other arm.
- Abduction of the shoulder: stand straight, your arms at your sides. Try to slowly lift one arm out to the side and then take it up (5 seconds, 10 times). Do the same with the other arm.
Isometric exercises for the injured shoulder:
- Internal rotation of the injured shoulder: standing just to the side of a doorway, bend the elbow of the injured arm and press the front of the wrist against the doorframe. Hold for 5 seconds (5 seconds, 10 times for one set. 3 sets are necessary).
- External rotation of the shoulder: standing in a doorway with your injured shoulder nearest to the doorframe. Bend the elbow and then press the back of the wrist against the doorframe (5 seconds, 10 times for one set. 3 sets are necessary).
- Extension of the shoulder: stand your back to a wall in a way that your bent elbows just touch the wall. Press your elbows back against the wall (5 seconds, 10 times for one set. 3 sets are necessary).
- Abduction of the shoulder: hold a pillow between the chest and arms. Squeeze the pillow (5 seconds, 10 times for one set. 3 sets are necessary).