Shoulder subluxation or dislocation is a common injury experienced by water polo players. It occurs when the shoulder is forcibly rotated or pulled out of its normal movement limits either by an external force, such as another players’ arm, or by an overstretch of the joint immediately following a maximal effort.  Players who experience subluxation or dislocation may have had instability present prior to the injury, and it occurs more readily in players who are naturally extremely flexible. It is an injury which commonly occurs in the younger athlete.

The main shoulder joint is essentially a shallow ball and socket joint which is held together by a capsule (connective tissue which encases the bones together), ligaments and muscles. Subluxation occurs when the arm bone (the ball of the joint) partially stretches out of the socket (the shoulder blade). In this situation the joint usually relocates easily but results in capsule, ligament and muscle strains. Dislocation occurs when the arm bone completely shifts out of the socket, and severe strain of the tissues that surround the joint will be inevitable.  A dislocated shoulder should be relocated at an Accident and Medical Centre under scanning to avoid pinching of important structures within the two bones. Fracture of the shoulder is also common with this injury, and this will also need to be eliminated at this time.  Those players who regularly sublux or dislocate their shoulder may be able to relocate it by themselves, but this is an indicator that they need rehabilitation! ACC Shoulder Clinical Guidelines also suggest for these people that a referral to a specialist is indicated. We can arrange and recommend this for you.

Physiotherapy for these conditions is imperative to: reduce swelling and scar tissue, improve strengthening of the stabilising muscles of the shoulder, release any muscles which are in spasm, and tape the shoulder for immediate stability. Physiotherapists will also give you sound advice on time frames to expect with this injury, activity modification, specialist referral and when you can return to the pool. We would be more than happy to see anyone who has recently subluxed or dislocated their shoulder, or anyone who has done this a while ago but feels they need treatment to return to full function and strength.

-Jenny Payne, Physiotherapist.