Shoulder pain – the subluxed shoulder

Many people experience shoulder pain and this can be very debilitating, following a stroke it is very common to experience shoulder pain. This can be caused by a number of different reasons from poor handling, scapular retraction, abnormal tone and shoulder subluxation.

Shoulder subluxation:
This is when there is low tone around the shoulder joint (glenohumeral) and with gravity this can often cause soft tissues to be pulled and overstretched. This results in pain around the shoulder.

Assessment:
During your time in hospital or when you return home, your stroke support team may review the extension of the subluxation by measuring the distance between the head of the humerus and the acromion (top of the scapula). They will also look at how the scapula is aligned to determine the full cause.
Intervention:

  • Follow guidelines set by your physiotherapist and occupational therapist. They may provide range of movement exercises to help facilitate normal function. It is important to follow this advice to avoid over stretching the joint
  • The arm can be supported to help reduce pain, they can be supported in a variety of different ways by a pillow in bed or in sitting and in a wheelchair pillow or a tray could be used (LINK), which will help reduce the risk of the muscles being pulled and being overstretched.

(picture by stroke4carers.org)

stroke ask the ot

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