A shoulder dislocation occurs when the head of the upper arm bone (humerus) separates from the glenoid socket of the shoulder blade. This injury often damages surrounding soft tissues, including ligaments, the labrum, and the joint capsule. The timeline for returning to exercise is highly individualized, depending on the type of dislocation (e.g., anterior) and whether surgical repair was required. Younger patients face a much higher risk of recurrent instability. It is imperative to receive medical clearance from a physician or physical therapist before attempting any exercise program.
The Immediate Aftermath and Initial Recovery Timeline
Following reduction, the shoulder enters a period of rest and protection to allow injured tissues to begin healing. This initial phase involves immobilization in a sling, typically lasting one to three weeks, but potentially up to six weeks depending on severity. The primary goal during this time is to control pain and inflammation using ice and anti-inflammatory medication.
Immediate, unsupervised exercise is discouraged because it can disrupt the healing of the joint capsule and ligaments, increasing the risk of re-dislocation. While the shoulder is immobilized, gentle exercises for the elbow, wrist, and hand should be performed to prevent stiffness. If surgery was performed, the immobilization period is often longer (four to six weeks) to ensure adequate tissue healing.
Phase One: Restoring Mobility and Range of Motion
The first phase of activity usually begins after immobilization, typically between weeks two and six, once acute pain has subsided. This phase focuses on restoring the shoulder’s natural movement and flexibility without stressing the healing joint structures. Movements must be gentle and performed within a pain-free range to avoid damaging vulnerable soft tissues.
A common starting point is passive range of motion exercises, where movement is generated by an external force rather than the patient’s own muscle effort. Examples include pendulum swings, where the patient leans over and lets the injured arm swing in small circles. Assisted exercises, such as using the unaffected arm or a rope and pulley system, are also used to gradually increase elevation.
The physical therapist guides the intensity and range of motion, setting limits on how far the arm can move, particularly external rotation, which stresses the anterior capsule. Older patients may begin this phase sooner (sometimes after one week) to counter the tendency for joint stiffness. Progression requires the restoration of full, pain-free range of motion before beginning strength training.
Phase Two: Progressive Strengthening and Stability Training
The strengthening phase typically begins between weeks six and twelve post-injury, only after full range of motion is achieved. The objective is to strengthen the dynamic stabilizing muscles of the shoulder joint to prevent future dislocations. This work focuses on the four muscles of the rotator cuff (supraspinatus, infraspinatus, subscapularis, and teres minor) and the scapular stabilizers.
Strengthening starts with low-load exercises, such as light isometric holds or exercises using resistance bands. Progressive resistance exercises often begin with internal and external rotation using bands, keeping the elbow tucked close to the body. The focus then expands to include scapular stabilizers, incorporating movements like shoulder blade squeezes or wall push-ups.
As strength improves, resistance is gradually increased, progressing to light free weights and cable machines. Prioritize strict, controlled form over the amount of weight lifted, as improper mechanics stress the recovering joint structures. Athletes and younger individuals, who have a higher rate of re-dislocation, often delay vigorous training until approximately three months post-injury for greater tissue healing.
Safe Return to Sport and High-Impact Activities
The final stage involves transitioning acquired strength and stability into activities mimicking daily life or sport-specific demands. This phase often begins around 12 weeks for non-surgical cases and four to six months for surgical repairs. It focuses on challenging the shoulder under stress and in positions where the dislocation originally occurred.
Returning to high-risk activities like throwing or contact sports requires meeting specific, objective criteria, not just a set time frame. Clearance mandates demonstrating functional and symmetric strength, aiming for 90% strength compared to the uninjured side, especially in the posterior rotator cuff. Functional tests, such as the Closed Kinetic Chain Upper Extremity Stability test, assess the shoulder’s readiness for competition. Long-term maintenance exercises focusing on rotator cuff and scapular strength are necessary to reduce the risk of future instability.