- (upbeat music) ♪ Bob and Brad
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet. ♪
- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together we are the most famous physical therapist
on the internet.
- In our own opinion of course Bob.
- He's right along with us.
- You better believe it.
- Okay. Teddy, Brad we're gonna talk
about posterior shoulder dislocation.
And is this your shoulder pain, I guess in the interest
of being complete, like we're gonna cover all subjects.
That's why we're covering this one.
- Right.
Well, we had, I had a viewer specifically asked for this.
I thought, well, we should really...
- Okay, sure.
- Should really cover it.
- So we did, have you ever seen a posterior dislocation?
- I have not.
- And I haven't either.
And that's between 50 years
between two of us of seeing patients.
- Right.
But it does happen and it's very interesting
I found it on who it does happen.
But let's look at what does happen.
- Well, first the percentage wise
Brad is only 2% to 4% of shoulder dislocation.
- Exactly.
- That's why we haven't seen it.
- Right. It's it's pretty small.
- It's pretty rare.
- Let's should we look at the mechanic of it?
Here we got the, the ball of the humorous, the
the shoulder joint into the glenoid fossa.
- The socket.
- And typically the shoulder comes out this direction.
Towards the front.
- That's the vast majority of them go
this way when they dislocate.
- Posterior means going to the backside ends up back here.
And one thing they did say a lot of times these get missed
because it is not real obvious, but it
if it's back far enough this bone right here,
the coracoid process, you can see
that protrude much more prominent.
- Yeah. I could see that.
So you, you know, you're looking
at the shoulder and you're gonna see a big bump here.
- Right. Exactly
- That's what that is.
- Okay. And then if you got gum behind your shoulder
he'll let you know.
(Bob laughing)
Anyways, let's, let's go on with that.
If this does happen.
Well, let's talk about who it happens.
So this is really interesting.
If you just look at that 2% to 4% and you'll put them
in a subcategory, 15% of these people who have bilateral
or bull shoulders
posterior dislocate, they're almost always
as a result of seizures.
- Wow. Interesting.
So they land, they have a seizure
and they fall in a certain way?
- No, they have a seizure and the muscles tighten up.
- Oh, you're kidding!
- Right. So much they pull the joint out of.
- Oh, so they happen to both shoulders at the same time.
- Yeah. They happen at the same time.
Okay.
- Interesting.
- Yeah, that, that was interesting.
And the majority of the rest of them are from trauma.
- Sure.
- Okay. Falling down car accident, motorcycle,
whatever it may be.
- Again, something very unusual
whereas the anterior dislocation can happen just from
you know, putting your arm out in the wrong position.
- Right, right.
- No trauma involved at all.
- And the age, most of them are between 35 and 55 years old.
- See an anterior dislocation coming forward.
That's gonna more often be a younger patient quite often
cuz they have the looser shoulders and it just
they pop out easier.
- Yep. Exactly.
Typically, if this happens
the arm internally rotates and abducts, so you kinda look
like this and it's painful particularly to go out
but pretty much any direction I would suspect would not
be comfortable, but this is how it looks when
that posterior happens typically.
- So if I come up to you, Brad
and I'm hurting my shoulders, like this?
- We're going to the ER.
- Okay, we're gonna check it out.
- Yeah. You can go on the internet and, and try
and read how to put it back in.
But I would definitely say go
to the ER, let somebody knows what they're doing.
- And that's with an anterior dislocation too.
I know I've seen people do it on their own.
I've seen a friend do it on his own.
But he he's done it many times, unfortunately.
- Yeah. Yeah.
That's that's another story.
- Yeah.
- As far as treating this, typically it's
in a sling immobilize it for about four weeks, depending
on how severe it is.
There may be surgery needed to, if it's things are a tore
the labrum, the rotator cuff, that kind of thing.
- Just like in any dislocation.
- Otherwise, you know, I think we could just do
some of our rotator cuff strengthening exercises
as long as it's not painful
- And we've got a lot.
We've got, I'll put them at the end here, Brad.
- Sure.
We got some videos on how to strengthen
after you've had a dislocation.
And, and some of the exercises you wanna do, we have one
on range of motion after dislocation.
We just did that one on...
- Very popular too.
These shoulder ones are, people want to know
about shoulder problems cuz there's a lot of shoulder...
- Very common to have issues like that so.
Most people got two shoulders.
So that's two injuries per person.
- This is a brilliant guy here.
(Brad laughing)
All right.
Thanks for watching.