We recently published some research about the impact of a traumatic shoulder dislocation on patients lives. It is called 'the glass shoulder' because on of the participants reported that this is what his friends call him because his shoulder is fragile and vulnerable. We thought that this title conveyed the sense ov vulnerability and fragility that often accompanies a traumatic shoulder dislocation
Fear after shoulder dislocation
We started this project as a way that we could learn more about fear of injury after a shoulder dislocation . We wanted to understand what type of fear people had after their shoulder injury. We thought that there might be a difference between fear of pain, fear of missing out, fear of the unknown, fear of the time involved in rehabilitation. We wanted to further understand what the fear was about, to then see if we could help reduce the fear with rehabilitation strategies
What we learnt about the impact of a traumatic shoulder dislocation
I was humbled to learn from our participants… they taught me about the enormous impact of a shoulder dislocation. I learnt how a shoulder dislocation impacts on their social identity because they can’t play the sports they used to, don’t get invited to events because of their shoulder. They taught me about the frustration when surgery (where they had pinned their hopes), was unsuccessful.
Sleep deprivation
Many patients talk to us about the lack of sleep after a traumatic dislocation, and we know that sleep is very important in recovery after injury.
Standing on the sidelines / Social Isolation
People who had experienced multiple dislocations talked about friends not inviting them to activities or sports events anymore because of their shoulder. They talked about how this made them feel socially isolated from their friends. They felt like they had an invisible injury that their friends couldn't see.
The emotional toll of rehabilitation
People in the research study talked about the emotional toll of a shoulder dislocation. They talked about the 'monotony' and the 'long road' of rehabilitation and how they sometimes struggled with motivation.They talked about rebuilding their confidence and hope after the dislocation.They found that having clear goals, a progressive rehabilitation programme, and positive feedback from the physiotherapist was motivating.
The compromise and risk management after a shoulder dislocation
Patients talked about the recovery process and living with their shoulder dislocation. They found some balance between the risk of injury and the activity they were involved in. They also talked about finding ways to stay engaged in their 'rehabilitation for life'
Treatment for traumatic shoulder dislocation
Patients reported that using only biomechanical explanations for their instability wasn’t helpful, and discussing the impact of their dislocation on the quality of their life was both hugely important to them, and facilitated trust in the recovery process.
Clinicians need to listen to their patients to understand the individual impact of how a shoulder dislocation has affected their patients. Patients also need to advocate for themselves to find clinicians who will support them through this rehabilitation process. Treatment needs to be centred on the patient, and focussed on not only their physical factors such as their strength, range of motion and control, but also the psychological impact of their injury including the vulnerability and fragility that can sometimes accompany this injury, especially in repeated dislocations.
I am enormously grateful to my co-authors on this study, Prof Gisela Sole, Dr Craig Wassinger, Anlo van Deventer and Leon Harris for this project. This is a very powerful piece of work.
If you want to read more about this research, you can access this paper free of charge
online here
If you are experiencing any of these factors that i have talked about above, please reach out to your physiotherapist, doctor or surgeon to discuss this. People in this study also talked about how reassuring it was to have a regular contact with therapists who could help with exercises, and offer different cues and support them through this recovery.
We also think that our shoulder braces at Flawless Motion can be used to limit the range of movement and provide more support to your shoulder, so check out the shoulder braces available at www.flawlessmotion.com for shoulder braces specific to your problem.
