Diagnosis Explanation:

Shoulder subluxation occurs when the humerus (upper arm bone) partially slips out of the shoulder socket but does not fully dislocate. This can result from weak ligaments, repetitive overhead activities, trauma, or prior dislocations. Subluxation increases the risk of future instability and chronic shoulder problems.

Symptoms:

• Feeling of looseness or slipping in the shoulder.
• Sharp pain, weakness, or numbness in the arm after certain movements.
• Clicking, popping, or grinding in the joint.
• Limited strength and difficulty lifting objects overhead.

Specific Work Modifications:

• If your job requires standing or walking: Avoid carrying weight on the injured side, and take breaks to rest the arm.
• If your job involves lifting: Avoid lifting, pushing, pulling, or repetitive overhead movements. Use both hands when possible.
• If your job is desk-based: Keep the shoulder supported, avoid leaning on the affected arm, and take posture breaks every 30 minutes.
• Avoid: Overhead reaching, repetitive shoulder use, and carrying heavy loads.

Specific Activity Modifications:

• If you play sports: Avoid contact sports, throwing, swimming strokes, or overhead racket sports until fully healed.
• If you do weightlifting: Avoid bench presses, overhead presses, dips, and pull-ups; instead, focus on controlled, pain-free movements.
• If you do yoga or Pilates: Modify poses to avoid excessive shoulder stretching, deep rotation, or weight-bearing on the arms.
• Avoid: High-impact activities, repetitive overhead motions, and exercises that cause shoulder discomfort.

Recommended Supplements:

• Collagen Peptides – 10g daily for ligament and joint repair.
• Vitamin C – 500mg daily to promote collagen synthesis.
• Glucosamine & Chondroitin – 1500mg/1200mg daily for joint lubrication and ligament health.
• Omega-3 Fatty Acids – 1000mg daily to reduce inflammation.
• Turmeric (Curcumin) – 500-1000mg daily for natural pain relief.

Recommended Nutrition and Hydration:

• Increase Lean Protein (chicken, fish, tofu, eggs) to support ligament and muscle healing.
• Eat Anti-Inflammatory Foods (berries, leafy greens, turmeric, nuts) to reduce swelling.
• Consume Hydrating Foods (cucumber, watermelon, citrus) to maintain joint lubrication.
• Limit Processed Foods & Sugars to prevent inflammation.
• Hydration: Drink 8-10 cups of water daily to support joint function.

Home Exercise Prescription (Rehabilitation for Shoulder Subluxation)

Early Phase (0-2 Weeks, Reducing Pain & Protecting the Joint):

• RICE Protocol – Rest, Ice (15-20 min, 3x/day), Compression, Elevation.
• Pendulum Exercises – Lean forward, let the arm hang, gently swing in small circles, 10 reps, 2x/day.
• Scapular Squeezes – Pinch shoulder blades together, hold 5 seconds, repeat 10 reps, 2x/day.
• Isometric Shoulder Holds – Press palm against a wall without moving the shoulder, hold 5 seconds, repeat 10 reps, 2x/day.

Strengthening Phase (2-6 Weeks, Improving Stability & Mobility):

• Wall Walks (Forward and Lateral) – Use fingers to "walk" the arm up the wall, hold 5 seconds, repeat 10 reps, 2x/day.
• External Rotation with Resistance Band – Keep elbow at 90 degrees, rotate forearm outward, 10 reps, 2x/day.
• Internal Rotation with Resistance Band – Keep elbow at 90 degrees, rotate forearm inward, 10 reps, 2x/day.

Advanced Phase (6+ Weeks, Preventing Recurrence & Maintaining Mobility):

• Lateral Arm Raises (Light Resistance) – Raise arms to shoulder height, 10 reps, 2x/day.
• Scapular Stability Exercises (Resistance Band Rows) – Pull resistance band toward chest, 10 reps, 2x/day.
• Modified Push-Ups (Wall or Knees) – Maintain control, 10 reps, 2x/day.

Helpful Books:

1. The Shoulder Pain Solution: Simple Exercises to Prevent and Recover from Injury – John M. Kirsch, MD.
2. Overcoming Shoulder Pain: A Guide to Rehabilitation and Recovery – Peter T. J. Barrett.

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.