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Dislocation of the shoulder

The shoulder anatomy is extremely complicated because it consists of 5 different joints. The shoulder complex is protected  and stabilized by numerous anatomical structures such as muscles and tendons of the rotator cuff. In some situations, such as severe contusions, this protection does not succeed to prevent the humeral head coming out from its position without returning spontaneously.

The humeral head can move forward, so called anterior dislocation (the most common), backward (posterior dislocation) or up (the acromion injury). The dislocation can also cause the detachment of the glenoid labrum, a kind of gasket, which allows the sliding of the humerus on the homonymous cavity of the scapula.

Following the traumatic event the shoulder requires an immediate intervention of reduction (repositioning) through a maneuver performed by the physician; then the arm should be immobilized by a brace for 1/2 weeks.

After removal of the brace it is important to begin, as soon as possible, the rehabilitation program that includes active and passive mobilization and pendulum exercises in the pool for the recovery of the fluidity and joint ROM; completed the range of motion recovery can begin the most important phase, the recovery of the strength of all the muscles that play an active role in shoulder stabilization: latissimus dorsi /pectoral, muscles the shoulder girdle, biceps, triceps, deltoids but especially intra-rotators and external rotators of the shoulder on all 3 planes, at first with isometric exercises and progressively through isotonic exercises with the use of elastic bands of increasing intensity.

More important than in other injuries is the recovery of the sport specific gesture in the field, starting with proprioceptive exercises and concluding with a good education to the movement and prevention of re-injury.
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