Lab shoulder subluxation

Question 1

Inferior shoulder subluxation

Answer 1

Issues: Downward rotation of scapula. Humerus: IR, ADD, humeral head below inferior lip of glenoid fossa. Elbow: extension and pronation

Handling strategies: reseat humeral head in glenoid fossa. Ensure alignment of GH joint. Facilitate. Support the extremity on a surface

• don’t let it dangle, pillow lap, caregiver assist.

Question 2

Anterior shoulder subluxation

Answer 2

ISSUES: Scapula: downward rotation, elevated & winging. Humerus: hyperextended, IR, humeral head inferior and forward of fossa. elbow: flexion, either supination or pronation.

HANDLING: Reseat humeral head in glenoid fossa. Ensure alignment of GH joint. Facilitate forward flexors of GH. Encourage supported forward reach. AVOID - hyperextension of the humerus with elbow behind GH joint

*Tendon pressure to biceps . Seated in with wide back so elbow can’t go back further. Use gravity to thread arm through shirt sleeve.

Question 3

Superior Shoulder subluxation

Answer 3

Issues: Scapula: elevated, ABD. Humerus: IR, ABD, humeral head lodged under acromion. Elbow: supination and wrist flexion.

Handling strategies: Encourage forward reach and discourage ABD of GH joint. Support reach with UE on a table surface. Work in small movement increments. Relax. hypertonicity and effort of movement.