A shoulder dislocation occurs when the head of the upper arm bone (humerus) completely separates from the shoulder socket (glenoid). This injury stretches and often tears the soft tissues that surround the joint, leading to instability and a high risk of re-injury. The primary goal following a dislocation is to restore the shoulder’s full function and prevent future episodes through a structured strengthening program. It is necessary to consult a healthcare professional, such as a doctor or physical therapist, before starting any exercise program to ensure it is appropriate for your specific injury and recovery stage.
The Phased Approach to Shoulder Recovery
Recovery from a dislocated shoulder involves a carefully managed, multi-stage process that prioritizes healing and safety before strength training begins. The initial phase is protective, typically involving immobilization in a sling for a period that can range from one to six weeks, depending on the injury’s severity and whether surgery was performed. This immobilization allows the stretched ligaments and joint capsule to begin healing without undue stress. During this time, gentle movement of the elbow, wrist, and hand is often encouraged to prevent stiffness in those adjacent joints.
Progression to the next stage requires clearance from a physical therapist or physician, signaling that the tissues have healed enough to tolerate movement. Starting active strengthening too early can be detrimental, potentially leading to a recurrence of the dislocation or further soft tissue damage. The intermediate rehabilitation phase shifts the focus from passive protection to active restoration of movement and flexibility before any resistance is introduced.
Gentle Exercises for Restoring Range of Motion
The first exercises after immobilization focus on recovering the shoulder’s natural movement without strain or resistance. These exercises are performed slowly and deliberately, using gravity or the uninjured arm for assistance. Pendulum exercises, also known as Codman exercises, are a common starting point, where the patient bends over and allows the injured arm to hang loosely, moving it in small circles or forward and backward motions. The weight of the arm itself provides a gentle traction that helps mobilize the joint capsule.
Passive range of motion exercises utilize the opposite, non-injured hand to support and move the injured arm through its available range. The healthy hand can help lift the injured arm forward, or use a stick or wand to assist in gentle overhead movements while lying on the back. The finger walk is a simple method where the patient faces a wall and slowly “walks” the fingers up the surface, stopping at the point of discomfort. These movements increase flexibility and reduce stiffness without engaging the weakened rotator cuff muscles. All exercises must remain within a pain-free range, as pushing into pain can aggravate healing joint structures.
Key Exercises for Shoulder Stability
Once full, pain-free range of motion is achieved, the rehabilitation progresses to resistance training, which is foundational for long-term shoulder stability. The primary focus of this phase is strengthening the rotator cuff and the scapular stabilizers, muscles that work together to keep the humerus centralized within the glenoid socket. Rotator cuff strengthening begins with isometric exercises, where the muscle is contracted without movement, such as pressing the bent elbow into a wall for several seconds to work on internal and external rotation.
These isometric holds are followed by dynamic exercises, typically using light resistance bands or very light dumbbells, such as one to three pounds. Internal and external rotation exercises with a resistance band, performed with the elbow tucked to the side, are crucial for strengthening the muscles responsible for stabilizing the joint during rotation. For external rotation, the band is pulled away from the body; for internal rotation, it is pulled inward toward the stomach.
Scapular stabilization exercises, like shoulder blade squeezes or prone rows, target the muscles of the upper back that control the movement and positioning of the shoulder blade. A stable scapula provides a solid platform for the arm to move upon, reducing stress on the joint capsule.
Progression must be slow and cautious, prioritizing high repetitions with low weight to build muscle endurance rather than maximum strength. Performing two to three sets of 15 to 20 repetitions is a common goal before safely increasing the resistance. Exercises should be performed three to four times per week, with rest days in between for muscle recovery.
Long-Term Maintenance and Injury Prevention
After formal physical therapy concludes, a sustained maintenance program is necessary to minimize the risk of recurrent dislocation. The strengthening exercises for the rotator cuff and scapular stabilizers should be integrated into a regular routine, ideally performed three to five times per week. This consistent engagement ensures that the supportive muscles retain the strength and endurance needed to protect the joint during daily activities and sport.
An important part of long-term prevention involves avoiding the “apprehension position,” which is the arm moved into an abducted (away from the body) and externally rotated position, as this places the greatest stress on the front of the joint capsule. Individuals should be mindful of this position during activities like throwing, swimming, or even reaching behind the car seat. Proper warm-up routines, including light cardio and dynamic stretching before any physical activity, also prepare the muscles for the demands ahead.