Subluxation

I got a question about a shoulder brace.  Here it is….

“I have subluxation on my left side. Not always. The KY helps. I would rather do shoulder shrugs with chanting & music than just counting .I also thought a brace -the criss cross cloth kind might help me hold my shoulders back. the left slumps forward.”

Does everyone know what subluxation is?  It’s the step before dislocation.  The joint is out of whack but not completely dislocated yet.  Now my initial reaction would be to say “no don’t get a shoulder sling.”  The reason is this…..We all know that nothing to us is more important than repetition…..which leads to neuroplasticity.  When you use a brace, neuroplasticity doesn’t happen because you’re not using the muscles.  I was at a course taught by Peter G. Levine and he was talking about using canes and said “we teach people to neuroplastically strengthen the wrong leg.”  He’s absolutely right.  The stuff about walking and transfers that a physical therapist teaches you is for SAFETY.  Getting a limb back to normal function is an entirely different story.  Entirely.  You pretty much have to do the opposite of all that safe stuff that your PT taught you in order to get stronger.  Disclaimer: do all the safe stuff.

Shoulders are a little different.  It’s not like walking or climbing steps where just doing the action will promote neuroplasticity.  The position of your shoulder has to be addressed before you use it.  Sooooo, I don’t know.  I never had a patient get a shoulder sling but I worked in orthopedics.  I never worked in neuro.  I also didn’t have this problem myself.  My shoulder never subluxed.  It hurt, but never subluxed.  So I don’t know.  Peter if you read this, what are your thoughts on this?  Like I said, I have no experience with shoulder slings for subluxation and can’t recommend one but this looks very good.



Categories: Health, Rehab, Stroke stuff

Tags: , , , , , ,

8 replies

  1. I have shoulder subluxation and I’m working on strengthening my rotator cuff. When I work those muscles the subluxation reduces, just temporarily so far, but it is no longer getting worse. Amy has great exercises for this (thank you Amy). I never wore a sling even though it was recommended to me. It just didn’t make sense to me. If you’re in a sling, you’re not using your arm which is just going to make it worse. A sling might make sense if you need it to reduce or eliminate pain.

  2. My shoulder was began to sublux a little at the inpatient rehab ward I was at, it hurt but later got better. My guess is address the position first, if that’s a danger, and using a joint out of proper position always is. Your body goes through enough stresses and strains as it is, so exercising anything outside its proper use is dangerous, A sling might not help the neuroplasticity of the brain, but your brain’s representation of your shoulder is not real, it’s just a brain map. Deal with real body parts first because they can cause real pain, then work on your brain map body parts when you’re sure it’s safe afterwards.

  3. The shoulder exercises were great, but I have also worn a sling to hold the arm in proper position while resting. It also helped reduce the pain I had while carrying around 7 lbs of dead weight while healing from an A/C separation. Otherwise I would have preferred doing without the sling. As far as the brace is concerned, you are better off holding and readjusting yourself into the proper posture and reminding yourself that this how it should be.

  4. my girlfriend had a stroke and ended up with a sublux shoulder I made this to help her https://sites.google.com/site/subluxationsling/home now every therapist that tries it recommends it

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