Behandelingen & onderzoeken Spoedeisende Geneeskunde

Dislocated shoulder (first time)

You dislocated your shoulder, with your upper arm shot forward out of the shoulder socket (anterior shoulder dislocation). The treatment consists of wearing a sling, having a short rest period and doing relevant shoulder exercises. To ensure a speedy recovery, we recommend that you contact a physiotherapist in the first week.

A dislocated shoulder, with the upper arm shot forward out of the socket, is something we see quite often. When the shoulder is back in place after repositioning it, the pain often eases immediately.

Schouder uit de kom

There are several tendons and muscles around the shoulder joint that keep the shoulder stable. Once the shoulder has been dislocated, in some cases these tendons and muscles can become damaged. This can cause long-term pain or other physical complaints. The risk of this damage increases with age (50+).

Summary

  • You dislocated your shoulder.
  • This injury usually mends well.
  • An outpatient check-up is generally not necessary, so a telephone appointment will be schedulded 10-14 days after discharge.
  • You will be wearing a sling for the first week. After your visit to the hospital, you can start training your shoulder as much as your pain or physical complaints allow.
  • Please find an instructional video for reapplying the sling in the Virtual Fracture Care app in the leaflet.
  • It is important that you start the exercises mentioned in this leaflet as soon as possible. This prevents the shoulder and other joints from becoming stiff.
  • Appropriate exercises can be found in this leaflet or in the Virtual Fracture Care app.
  • By training your muscles you reduce the chance that the shoulder will dislocate again.
  • We advise you to always contact a physiotherapist to help you recover. In men over 35 in particular, this really contributes to preventing the shoulder from dislocating again.
  • If you have any questions or problems during the recovery, do not hesitate to contact us on workdays from 10:00 AM – 12:00 PM via the ‘Breuklijn’ (fracture hotline): T 088 320 14 23. This line is easily accessible in case your pain does not subside.

Is the pain getting worse, has the pain/stiffness not reduced after 2 weeks, or are you behind in the exercise schedule? Please contact the 'Breuklijn' (fracture hotline): T 088 320 14 23. If a check-up seems necessary, we will schedule an appointment. The 'Breuklijn' is easily accessible, so please use it to prevent any issues in the long run.

Treatment

The treatment consists of wearing a sling, having a short period of rest and doing specific shoulder exercises. By training your muscles you reduce the chance that the shoulder will dislocate again. This also reduces the risk of pain and stiffness in the shoulder. 

Important! It is important that you contact the 'Breuklijn' (fracture hotline) if your complaints (pain and/or stiffness) do not improve after 2 weeks, or if you are behind in your exercises. You can use the exercises at the bottom of this leaflet as a guideline for what you should be able to do and when. Please contact us for any question you may have in order to avoid problems with your recovery.

First week (Week 0)
  • If you can, use the sling for support.
  • Train your shoulder as much as your pain or physical complaints allow.
Week 1-6
  • Stop wearing the sling.
  • Train your shoulder as much as your pain or physical complaints allow.
Week 6 onwards
  • Use your shoulder as you were used to before your injury, depending on the complaints.
  • Keep repeating the exercises until your shoulder functions normally again.
  • You can resume sports or gymnastics. It can take up to 3 months before all physical complaints are gone.

Important! In the first 2 weeks, do not:

  • ift the arm forward,
  • turn it outward,
  • lift it to the side, and/or
  • extend it backward.

This prevents the shoulder from dislocating again. For example, you should avoid the movement of combing back your hair.

Instructions

The following instructions are important to allow for a good healing:

  • Have you received a sling? Use it for the first week to give the shoulder a rest. When you go to sleep you can take off the sling.
  • Please find instructions for reapplying the sling in the Virtual Fracture Care app. (hyperlink video, in app version)
  • You can immediately start exercising as much as your pain or physical complaints allow. It is important that you start exercising in time to prevent shoulder stiffness.
  • A physiotherapist can help you recover. We advise you to contact a physiotherapist within 1 week. Make sure that your physiotherapist has experience in treating dislocated shoulders. We recommend that you call in a physiotherapist - especially for men over 35 - who will help prevent your shoulder from dislocating again.
  • In the first 2 weeks, do not lift the arm forward, do not turn it outward, do not lift it to the side, and do not extend it backward. This prevents the shoulder from dislocating again. For example, you should avoid the movement of combing back your hair.
  • Use your arm and shoulder depending on your physical complaints. This means you can use the arm and shoulder for as long as you can tolerate the pain.
  • You can find the exercises and instructions in the Virtual Fracture Care app or in the leaflet.
  • You are not allowed to play sports for the first 6 weeks. After that you can slowly start exercising, as far as your pain complaints allow. It can sometimes take up to 3 months before you can exercise without complaints.
  • Do you have pain? Use paracetamol if needed. Do not wait to take paracetamol until you are in too much pain. Always take it throughout the day. You can take 2 tablets of 500 mg paracetamol up to 4 times a day at fixed times. If your complaints persist, please contact us via the 'Breuklijn' (fracture hotline).

Rehabilitation exercises

After your shoulder has been dislocated in a forward motion, you may experience shoulder stiffness and loss of strength. Below are some specific exercises you can do to prevent this as much as possible. You can also find them in the Virtual Fracture Care app. During the first week it is wise to wear the sling for support.

Important! Do not overstep your own physical limits while exercising. Pain can be a sign of overexertion. If you feel pain, stop exercising. You may feel fatigue or muscle aches.

Do not proceed to the next step in the exercises until you are able to perform the previous exercises. Keep repeating the exercises from the previous weeks.

We advise you to go to a physiotherapist during your recovery, to guide you through the exercises.

Week 1

Train your shoulder as much as your pain allows. If you want, use the sling for support.

Repeat the following exercises 3 to 4 times a day.

Exercise 1

Move the fingers and wrist by making a fist 10 to 15 times.

Exercise 2

Straighten and bend your elbow 10 to 15 times.

Exercise 3

Press your forearm against your stomach. Hold this position for a few seconds and let go. Repeat this 10-15 times in a row.

Exercise 4

Press your forearm against the side of your chest. Make sure your forearm is against your stomach. Hold this position for a few seconds and let go.  Repeat this 10-15 times in a row.

Exercise 5

Bend over slightly and make small circular motions with your elbow (pendulum movement) (see picture 1). Repeat this 10-15 times in a row.

Cirkels maken met je elleboog

Week 2

Take off the sling as far as pain allows. Try to keep it off as much as possible from now on.

Repeat the following exercises 3 to 4 times a day.

Exercise 1

Press your stretched forearm against the side of your body. Hold this position for a few seconds and let go (see picture 2). Repeat this 10-15 times in a row.

Druk uw gestrekte arm tegen de zijkant van uw lichaam

Exercise 2

Bend over slightly and let your arm hang down, stretched. Make small circular motions, clockwise and counter-clockwise (see picture 3). Repeat this 10-15 times in a row.

Ga iets gebukt voorover staan en laat uw arm gestrekt naar beneden hangen. Maak kleine cirkelbewegingen.

Exercise 3

Bend and stretch the elbow while bent forward (see picture 4). Repeat this 10-15 times in a row.

Buig en strek de elleboog, terwijl u gebukt voorover staat

Week 3

Repeat the following exercises 3 to 4 times a day. Alternate the exercises.

Exercise 1

Move your hand over your chest towards your healthy shoulder and try to tap the shoulder blade. Support your elbow with your other hand (see picture 5). Repeat this 10-15 times in a row.

Ga met uw hand over uw borstkas naar de gezonde schouder en probeer het schouderblad aan te tikken. Ondersteun uw elleboog met uw andere hand

Exercise 2

Place your hands against each other in front of your chest and press them together. You will feel the muscles at the front of your shoulder working (see picture 6). Repeat this 10-15 times in a row.

Plaats uw handen tegen elkaar aan voor uw borstkas.

Exercise 3

Stretch your arm. Bring it forward and lift it to shoulder height (see picture 7). Try to hold the arm here for a moment. Repeat this 10-15 times in a row.

Strek uw arm. Breng deze naar voren en til omhoog tot schouderhoogte

Exercise 4

Lift your stretched arm sideways up to shoulder height. If necessary, use a wall for some support (see picture 8). Try to hold the arm here for a moment. Repeat this 10-15 times in a row.

Til uw gestrekte arm van u af naar de zijkant tot aan schouderhoogte.

Exercise 5

Move your arm backwards slowly with a stretched or bent elbow (see picture 9). Repeat this 10-15 times in a row.

Beweeg de arm rustig met een gestrekte of gebogen elleboog naar achteren

Week 4-6

  • Repeat the exercises from week 3, now gently lifting the arm above shoulder level. You may move your arm as far as the pain allows.
  • Try to do exercises 3 and 4 (from week 3) while giving some counter pressure with the healthy arm, so against resistance. Train your shoulder as much as your pain allows.
  • Alternate the exercises and perform them at a leisurely pace. Repeat 3 to 4 times a day.

Week 6 onwards

  • Continue the exercises from the previous week until you feel that the shoulder can do the same as you could before the shoulder dislocated.
  • Swimming is a good exercise to get the shoulder function back to normal. 
  • Continuing to strengthen the muscles around the shoulder through exercise and sports reduces the risk of dislocating the shoulder again.

Recovery

  • Generally, a check-up at the outpatient clinic is not necessary. It may take up to 6 weeks before you can fully use the arm and shoulder again.
  • Once the shoulder has been dislocated, it is more likely to dislocate it again. This is especially the case in young (male), active adults. It is therefore very important to properly exercise and train the shoulder. This strengthens the muscles and makes the shoulder more stable. Moreover, it reduces the chance that the shoulder will dislocate again.
  • Is the pain getting worse, has the pain not subsided after 2 weeks, does the shoulder feel unstable or stiff, or are you behind in your exercising schedule? Please contact the 'Breuklijn' (fracture hotline): T 088 320 14 23. If a check-up seems necessary, we will schedule an appointment.

Virtual Fracture Care app

Find more information about your injury in our app. The app also includes exercises that promote your recovery. You can find the app in the App Store (iPhone) or Google Store (Android). You can also scan the QR code. You will then automatically be redirected to the app.

QR-code Virtual Fracture Care app

Questions? Please call the 'Breuklijn'

If there are any questions after reading this information, please call our 'Breuklijn' (fracture hotline) on workdays between 10.00 and 12.00 via 088 320 14 23.

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