SHOULDER SUBLUXATION AFTER STROKE:
Shoulder subluxation is a common post-stroke complication affecting up to 80% of the stroke subjects . The glenohumeral joint is multiaxial and has a wider range of motion than other joints. It can be measured in finger width, such as 1 finger or 2 finger width separation, or subluxation.
CAUSE: Shoulder subluxation is a common occurrence after stroke and can be due to muscle weakness or spasticity. It is characterized by the upper arm bone (humerus) dropping out of the shoulder socket.
TREATMENT IMMEDIATELY FOLLOWING STROKE: Classic treatments for shoulder subluxation include shoulder slings, closed reduction (manipulating the shoulder back into position), and medication. Supporting the Shoulder while standing, in a wheelchair, and even while lying in bed is extremely important.
NEVER, PULL OR TRY AND SUPPORT THE STROKE SURVIVOR ON THE STROKE AFFECTED ARM, ALWAYS STAY ON THEIR STRONG OR UNAFFECTED SIDE, SO IF YOU NEED TO PREVENT THEM FROM FALLING, YOU CAN DO SO BY CATCHING THEM ON THEIR STRONG SIDE, PLUS BEING ABLE TO HOLD ONTO YOU WITH THEIR STRONG ARM WILL GIVE THEM A SENSE OF CONFIDENCE, WHICH IS IMPORTANT WHEN THEY ARE TRYING TO STAND AGAIN OR TAKE THEIR FIRST STEPS. BELIEVE ME, IT IS SCARY!
Mobility issues like shoulder subluxation after stroke are best treated by retraining the brain and the body how to communicate effectively
- Primary treatment will involve rehabilitative exercise. Shoulder braces and medication may also be used to ease the symptoms and/or pain while rehabilitation is in progress. Always consult a Physical Therapist for the correct exercises for you, at your stage of recovery or severity of the subluxation / separation.
Kinesio Taping: This involves placing gently stretched pieces of kinesio tape on your upper arm and shoulder to stimulate the muscles.
The tape will provide a light supportive pull to remind your muscles to work to pull the humerus back into the shoulder joint. This may also help to reduce pain. Ask your therapist which kinesio taping method may be appropriate for you.
Watch this video on taping
When the arm is completely paralyzed, one of the best ways to introduce movement is with electrical stimulation. Your brain communicates with your muscles using electrical impulses, and e-stim helps facilitate this process. Electrical stimulation helps reconnect your mind to muscle by telling your brain, “Hey! There’s an arm here! Let’s get it together!” Electrical stimulation helps “wake up” the muscles around your shoulder and, in time, your arm will go back into its socket. You should consult your therapist to find the best settings and placements for the electrodes. Also, even if your arm is not paralyzed, electrical stimulation may still help. See videos at the bottom of this page.
IF EVERYTHING ELSE FAILS YOUR PHYSICIAN MAY SUGEST SURGERY
- Surgery because it addresses the root cause of the problem: communication from the brain.
I suffered Shoulder Subluxation when I suffered my Strokes in 2016, and 5 years later, I am still dealing or suffering with it. I am now switching to Electrical Muscle Stimulation using the SaeboStim Pro. I have attached a videos and explaining how to use EMS or ELECTRICAL MUSCLE STIMULATION to correct Shoulder Subluxation, along with the electrode placement for many other Neurological related injuries. Hopefully you will find them educational.
The Saebo Stim Pro is not available in Canada, but at JGH Rehab, we carry a TENS / EMS Combo, which will basically use the same pad placement on program 12, ensuring the the BLACK lead wire is always placed in the higher position. We will have the Shoulder Subluxation pad placement position of the Phase 5, on our website very soon. Contact us for details at www.jghrehab.ca
ELECTRODE PLACEMENT SHOULDER SUBLUXATION
Video showing electrode placement using the Saebo Stim Pro.