A dislocated shoulder is one of the more dramatic injuries in sport and in falls: the ball of the upper arm bone comes out of its shallow socket, usually forward, and the arm hangs in a position that feels deeply wrong. Emergency care puts it back. Then comes the part that decides your future with that shoulder, because once a shoulder has dislocated, it has a real tendency to do it again, especially in the young.
Why shoulders dislocate, and re-dislocate
The shoulder trades stability for mobility, it has the largest range of motion of any joint, on a socket the size of a golf tee. A first dislocation typically tears the labrum (the socket’s rim, the “Bankart lesion”) and stretches the capsule and ligaments that stabilise the joint. Those structures heal imperfectly, which is why recurrence is common. The single strongest predictor, shown consistently across studies, is age at first dislocation: teenagers and people in their twenties re-dislocate at high rates; first dislocations after 40 recur far less often (but carry more risk of associated rotator cuff tears instead).
What the immobilisation research says
A systematic review and meta-analysis in the Journal of Bone and Joint Surgery examined position and duration of immobilisation after a first anterior dislocation. Two findings worth knowing: keeping a younger patient in a standard sling for longer than about a week did not reduce recurrence, stiffness was the main harvest of longer immobilisation, and bracing in external rotation showed a trend toward fewer recurrences than the conventional sling (25% versus 40%), though the numbers were not conclusive. The practical takeaway: endless sling time is not protection. Early, guided rehabilitation is the treatment after the brief rest period, and for young, active first-time dislocators, a surgical opinion about stabilisation is a reasonable conversation to have early, because their recurrence odds with rehab alone are genuinely high.
What rehab rebuilds
- Range of motion, restored progressively, respecting the healing capsule: some directions are deliberately limited early, external rotation especially
- Rotator cuff and shoulder-blade strength, the dynamic stabilisers that substitute for the damaged static ones
- Proprioception and reaction, retraining the shoulder’s position sense and its ability to respond to a sudden load or fall
- Graded return to sport, contact and overhead sports come last, when strength, control, and confidence all test well; a shoulder that “feels fine” doing nothing has not been tested at all
After stabilisation surgery
If the shoulder is surgically stabilised (arthroscopic Bankart repair is common), rehab follows the surgeon’s protocol: sling for several weeks, motion restored in protected ranges, strengthening from about three months, and return to contact sport rarely before six months. The discipline in the early, boring phase is what the later phases are built on.
Seek care promptly if
The shoulder will not stay in, dislocates again with minor force, or you notice persistent numbness or weakness in the arm after the injury, these change the management conversation, usually toward surgery.
References
- Paterson WH, et al. Position and duration of immobilization after primary anterior shoulder dislocation: a systematic review and meta-analysis of the literature. Journal of Bone and Joint Surgery (American). 2010;92(18):2924–2933. PMID 21159993
General information only, not medical advice. A dislocated shoulder needs emergency care; rehabilitation should follow assessment of the specific injury.