Shoulder Subluxation after stroke – exercises and treatment

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Research has shown that most patients with a hemiplegia after a stroke suffer from a condition called shoulder subluxation. The incidence is higher in more severe cases of paralysis, however shoulder subluxation is one of the most common secondary musculoskeletal complaints post stroke. There are various ways to treat shoulder subluxation.

Also referred to as joint instability, a subluxation is medically defined as less than a dislocation. This can mean that the relationship of the joint surfaces has been challenged but not so much as a dislocation. With regards to the shoulder the ball of the upper arm bone has lost it’s normal relationship with the shoulder socket due to the pull of spastic muscles.

Shoulder Subluxation after stroke

Shoulder Subluxation after stroke

Treatment can include ice or heat packs, pain killers, support devices, and strapping or taping the shoulder to reduce pain plus various other forms of therapy discussed below.

1. Closed Reduction and Immobilization
This is a medical procedure where the head of the humerus (top of the arm bone) is restored to it’s normal position by applying traction to the arm. After this procedure the arm is immobilized for 4 weeks with supportive devices to prevent any movement. The types of devices used can be cuffs, slings, and braces. It is important not to overuse these supports as it can lead to excessive immobility and encourage spasticity.

2.Prolotherapy
This is also a medical procedure with a combined natural approach. A solution is injected into the affect joint and surrounding supportive tissue to stimulate a natural inflammatory and healing reaction in the body. The theory is inducing this reaction will help heal the subluxated shoulder.

3. Electrotherapy
Continuous treatment with electrical stimulation of the shoulder muscles can help reduce subluxation.

4. Exercises
Specific tailored shoulder strengthening exercises can be used to help improve weak muscles and help relax tight ones. Shoulder stabilizing exercises that work on the scapular muscles and rotator cuff muscles are recommended. Proceed with caution and start slowly.

5. Proper positioning
This involves trying to maintain the correct posture during your everyday activities. This is easier said than done and will require conscious effort when first starting out.

What did you find helpful for your shoulder subluxation? Leave your comments below.

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