Many users of different ages are interested in how to straighten a shoulder on their own and what is needed for this. It is worth immediately noting that the reduction of dislocations of any type must be performed by a qualified specialist.
As a result of injury, the victim is significantly limited in his usual social life. Ignoring deviations leads to the development of serious complications. Optimization of physical processes in the body will not occur until the problem is eliminated. Pre-medical care plays a huge role.
pathogenesis
pathogenesis
The shoulder has a complex structure; its base is made up of three bones. The joint consists of the head of the humerus, which is located in a cavity consisting of the articular surfaces of the clavicle and scapula. Since this joint has the ability to provide high mobility of the arm and low stability, it is often subject to dislocation or popping out.
In this case, the head comes out of the socket of the joint. Stretching and tearing of the ligaments that provide strength and stability to the shoulder lead to the fact that they cannot “hold” the head and it comes out of the socket. This pathogenesis is the basis for the development of habitual dislocation.
Symptoms
Violation of the shoulder anatomy occurs after a sharp push from an outstretched arm or a strong blow to the back in the joint area. After the characteristic pop with which the bone leaves its place, the victim feels a sharp piercing pain.
Visually diagnosed:
- Deformation;
- Hematomas;
- Depression on the deltoid muscle;
- Immobility of the arm and rapid swelling of the shoulder;
- The injured shoulder is located lower than the healthy one;
- The surface of the palms becomes numb or feels tingling.
About a quarter of dislocations are accompanied by bone fractures. If the blood supply is disrupted, the hand and forearm of the injured arm will become cold and acquire a bluish tint.
Causes
The fact that the shoulder joint often pops out is caused by the influence of several contributing factors, so the pathological condition is classified as polyetiological. Such factors include:
- Congenital weakening of the ligamentous apparatus, in which instability develops already from the birth of the child.
- Suffered injury associated with excessive simultaneous impact on the shoulder, which causes stretching and rupture of the ligaments with the head coming out.
- Gradual sprain of the shoulder ligaments, which occurs due to increased loads on it.
- Chronic inflammatory processes in the structures of the shoulder, leading to a gradual decrease in the strength of the ligamentous apparatus.
Knowledge of provoking factors allows for effective prevention of habitual shoulder dislocation.
Health-improving gymnastics complex
Perhaps the most important element of the recovery process is physical activity. The set of classes is aimed at quick and effective recovery of the injured organ after surgery. Health-improving gymnastics will help tone muscle tissue, improve blood circulation, and also stabilize the condition of the shoulder joint.
The very next day after realignment of the shoulder joint, the patient needs to begin health-improving procedures. Since the dislocated joint is completely immobilized, it is necessary for blood to flow into it. Therefore, it is recommended to conduct passive therapeutic exercises:
- with the hand of the injured limb you need to make circular movements in different directions;
- apply compression with the same limb, but at the first stage you cannot use weighting objects - this can cause injury;
- try to tense the muscles, while the joint itself should remain motionless.
After day 20, you can do slightly more complex exercises. By this time, the tissues and ligaments should gradually become stronger. In this case, the lesson is already carried out without a fixing bandage.
All movements are performed with the injured hand:
- the lesson must begin with a warm-up in order to tone the muscles and prepare them for a more complex load;
- in the first exercise it is necessary to tilt the shoulder joint forward, this leads to flexion of the ligaments;
- in the second exercise it is necessary to move the joint back, this is necessary to straighten the ligaments.
When performing the complex, you must adhere to a moderate pace. There is no need to rush, as you can accidentally damage the organ. The lesson should last no more than half an hour, but the entire set of exercises must be performed about 5 times a day. If performed systematically, the effect of the exercises will occur much earlier, and the damaged joint will quickly restore its functionality.
After 30 days, the patient usually removes the bandage if there are no complications, and the recovery process occurs according to the treatment. When performing a gymnastic set of exercises, it is necessary to be careful and not make sudden movements so as not to harm your hand. Most often, doctors prescribe the following exercises:
- it is necessary to perform active actions with the shoulder joint back and then forward;
- in order to improve blood flow, you need to work with your fingers, so it is imperative to perform exercises on flexion and extension of the lower part of the limb;
- It is also necessary to include in the lesson an exercise for raising and lowering the arm - this will allow you to develop the shoulder joint;
- the patient should perform exercises to rotate the limbs;
- It is recommended to raise your arms to the sides, as well as behind your back.
Physical activity can be gradually increased, but the exercises should not cause discomfort or pain. If this happens, then it is necessary to exclude this exercise until the recovery process is completed. All classes must be carried out daily, then the result will be noticeable. And the person will be able to quickly restore lost motor function. However, you must remember that you cannot strain the shoulder joint too much; all exercises must be done in moderation.
Who is at risk?
Shoulder injuries often occur after a traffic accident, in various industries, among athletes, as well as among young active people. After a primary dislocation, the likelihood of re-extrusion of the humeral head increases significantly, as there is a significant violation of the integrity of the ligament fibers.
Gradual sprain of the shoulder ligaments usually occurs in people of certain professions (painters, plasterers), as well as athletes (people involved in swimming, tennis, volleyball). Prolonged inflammation can be caused by an autoimmune condition or infection.
kinds
Types:
Complete and incomplete dislocation are distinguished. With complete dislocation, the head completely comes out of the socket with loss of shoulder function, and it is almost impossible to perform any movements with the upper limb. With a partial dislocation, the function of the shoulder is not complete, but is preserved. Depending on how long ago the humeral head came out, the dislocation can be fresh or old (old dislocation is the result of the lack of provision of the necessary qualified medical care).
Dzhanelidze method
I give the patient an intramuscular injection of an anesthetic drug. The victim is placed on the table so that the limb hangs down and the edge of the table rests on the axillary area. Next, the traumatologist acts on the forearm and simultaneously performs a full rotation of the affected arm around its axis. Thus, the hand independently comes to the correct position. Reduction does not take much time, and the patient recovers faster.
Symptoms
A popping shoulder joint is indicated by the appearance of several characteristic symptoms:
- Pain that accompanies damage to soft or hard structures immediately at the moment the head emerges. The intensity of discomfort with repeated dislocation decreases with each subsequent exit of the head from the socket.
- Deformation (change in shape) of the shoulder area with the formation of a significant protrusion (the area where the head of the humerus emerges) or a depression.
- The addition of inflammatory signs, which include redness (hyperemia) of tissues, as well as their swelling.
- Impaired shoulder function, which is characterized by the inability to perform movements in it. With partial dislocation, the range of motion decreases sharply.
With each subsequent dislocation, the severity of clinical manifestations decreases. Shoulder dysfunction comes to the fore. A subjective feeling of discomfort appears in the form of “looseness” of the shoulder joint, as well as the appearance of clicks when trying to move it.
Diagnostics
In order to reliably establish that the shoulder joint is popping out, the orthopedic traumatologist, after a clinical examination (questioning, examination, palpation), prescribes objective additional studies. These include radiographic examination with visualization in frontal and lateral projection.
If necessary, to obtain additional information about the causes of habitual dislocation, tomography, laboratory tests, ultrasound, and arthroscopy may be prescribed. Arthroscopy can be performed not only for diagnostic purposes, but also for plastic surgery of various structures. This is due to the fact that together with the arthroscope, special instruments can be inserted into the shoulder cavity.
Principles of treatment
If it has been determined that the shoulder joint is popping out, only comprehensive treatment is prescribed. The main goal of therapeutic and rehabilitation measures is to restore the strength of ligaments and other connective tissue components, as well as their normal condition. Treatment tactics are determined, which may include:
- Conservative treatment.
- Surgical intervention.
- Rehabilitation procedures.
The type and duration of treatment and rehabilitation measures are established by a medical specialist individually based on all the results of an additional objective study.
Possible complications
Shoulder dislocation has a number of consequences for the patient:
- after reduction, a person may feel pain for a long time;
- development of osteoarthritis - this disease is an inflammation that is caused by damage to cartilage;
- periarthritis glenohumeral disease;
- injury to the nerve ending, which subsequently leads to muscle numbness.
The most common complication is repeated dislocation of the joint. According to statistics, if an injury occurs at least twice, then there will be more to follow. With each new illness, the joint will be severely destroyed. In medicine, this condition is called chronic dislocation.
Exercise strengthens the muscle structure, improves blood circulation and improves tone, which can help prevent shoulder dislocations from happening again. However, the patient must undergo therapeutic exercises daily and perform all movements correctly.
If you devote little time to exercises and do not do them systematically, there will be no improvement. When performing a set of exercises, it is worth considering the fact that the load should not be strong, as this can provoke another dislocation. Therefore, when practicing, a moderate pace must be used.
If dislocations recur quite often, then surgical intervention is necessary. Surgeons most often use the Bankart method. This technique is not painful and does not cause visible damage to the skin. The operation is performed endoscopically. However, after it the patient will have to undergo long-term rehabilitation.
Conservative therapy
The primary measure of conservative treatment for habitual shoulder dislocation is modification of the patient’s life and behavior. The load on the shoulder joint is temporarily limited to ensure sufficient restoration of the ligamentous apparatus. If there is a significant inflammatory reaction, non-steroidal anti-inflammatory drugs are prescribed.
In the future, physiotherapeutic procedures are used. These include magnetic therapy, mud baths, electrophoresis with drugs. An alternative modern option for conservative therapy is the intra-articular injection of platelets containing “growth factors”. They stimulate the processes of restoration of the fibers of the ligamentous apparatus. The effectiveness of conservative therapy is assessed several months from the start of its implementation.
Physiotherapy
Experts strongly recommend undergoing physical therapy procedures for dislocations. Since it allows you to restore motor function, as well as strengthen muscle tissue that was damaged by injury. This procedure is absolutely harmless and cannot cause harm to the patient. Physiotherapy is an effective procedure that has the following effects:
- aimed at relieving swelling at the site of injury;
- significantly reduces pain;
- is able to resolve blood clots that have formed in tissues;
- improves blood circulation;
- organs and tissues receive oxygen in full;
- The healing process takes place much faster.
Paraffin treatments also have a positive effect. Typically, physical therapy is prescribed a few days after the injury occurs.