How to Treat Shoulder Subluxation After Stroke – A Complete Guide

how to treat shoulder subluxation after stroke (and how to prevent it from getting worse!)

If you want to treat shoulder subluxation after stroke, this article will cover everything you need to know.

Today you’ll learn:

  • What causes shoulder subluxation after stroke
  • 2 steps to effectively treat this stroke side effect
  • How to correctly (and incorrectly) use an arm sling

Let’s get started.

Identifying Shoulder Subluxation After Stroke

Shoulder subluxation happens when the upper arm bone “drops” out of the shoulder socket.

The shoulder socket is already a vulnerable joint. It has a lot of mobility – almost too much for its own good. (How many people do you know with shoulder injuries? This is why.)

Due to the shoulder’s vulnerabilities, it becomes even more susceptible to problems after stroke.

When the muscles around the shoulder become paralyzed (or “flaccid”) after stroke, it can cause the arm to become dislocated from the shoulder socket.

Sometimes shoulder subluxation goes away on its own and the arm naturally goes back into its socket.

Other times, treatment is needed.

How to Treat Shoulder Subluxation

Here are the steps used to treat shoulder subluxation during rehabilitation.

Step 1: Bring on the e-stim!

When the arm is completely flaccid (stage 1 in the Brunnstrom stages of stroke recovery), the best way to introduce movement is with electrical stimulation.

Your brain communicates with your muscles using electrical impulses, and e-stem 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 placement for the electrodes. (They should go somewhere around your shoulder joint, and your therapist can get specific with you.)

Step 2: Bring on the exercises!

The second step is to continue to reconnect your mind to muscle with rehab exercises.

Rehab exercises will help retrain your brain (through neuroplasticity) how to control your arm muscles.

With enough massed practice, your arm will slowly go back into the shoulder socket.

Be veerryyy careful not to overwork or strain your shoulder during rehab! This could make things much, much worse.

Instead, start with gentle exercises. For example, the weight bearing lean stretch from our shoulder rehab exercise guide is a great place to start.

As you begin to regain movement and stability in your shoulder and arm, you can progress to more difficult exercises.

How to Use Slings for Shoulder Subluxation

If you have shoulder subluxation, then you might have an arm sling or might be considering getting one.

It’s important to understand that there’s a right way and wrong way to use slings for shoulder subluxation.

We’ll discuss both.

1. How to Make Things Better

If your arm is totally flaccid and/or your shoulder is in pain, then you’re a great candidate for a shoulder subluxation sling.

A sling can help reduce pain and prevent people from pulling on your arm (which would make the condition much worse).

It’s essential to understand that a sling is a compensation technique, though, which can prevent you from achieving a full recovery.

To keep yourself on track to your highest recovery, your long-term goal should be to regain use of your arm through e-stim and rehab exercise.

A sling is a great tool for the short-term, but don’t lose sight of your long-term goal.

2. How to Prevent Things from Getting Worse

What if you have some movement in your arm? Should you use a sling?

The answer is: not if you can help it.

If you have some movement in your arm, then a sling will prevent you from using it. And if you don’t use it, you’ll lose it.

While slings are a great way to keep your arm safe when you’re out in public, try your best to get as much informal therapy as possible through your activities of daily living.

By moving your arm as much as you can, you will help reconnect mind to muscle.

When you get this informal therapy along with formal therapy (i.e. your shoulder rehab exercises) your arm will slowly go back into its socket.

Emphasizing repetitive practice is the best treatment for shoulder subluxation.

Summary: How to Treat Shoulder Subluxation

Overall, shoulder subluxation after stroke can be effectively treated with electrical stimulation and rehab exercise.

Both of these techniques help reconnect mind to muscle, and eventually your arm will go back into its socket.

If you’re in pain or have a completely flaccid arm, then you might want to consider investing in a sling to help you in the short-term. Your therapist is a great person to consult about this.

However, know that slings are a compensation technique. If you want a full recovery, be sure to use e-stim and shoulder exercises to outgrow the need for a sling.

And there you have it! Did this answer all your questions about shoulder subluxation after stroke? If not, leave us a comment below and we’ll help you out!