JOINT SUBLUXATION

SUBLUXATION:
Subluxation is a common post stroke complication affecting up to 80% of the stroke subject.
Subluxation is defined as a partial or incomplete dislocation that usually stems from changes
in the mechanical integrity of the joint.
A joint is subluxated when its articular surfaces are only partially displaced and retain some
contact between them
Shoulder subluxation is a restricted part of shoulder joint. Shoulder joint is the connection
between head of humerus and glenoid cavity of the shoulder blade and associated muscles are
ligaments help to hold the joint in a correct position and give stability of the joint. Shoulder
subluxation occurs when holding tissues become weak and do not provide the stability at the
joint. Dislocation and subluxation is not a same type of disorder. In dislocation, the humerus is
fully perturbed from glenoid cavity.
• The shoulder subluxation occurs due to injuries in associated tissues like labral
tears and arm bone injury specifically lesions in humeral head, causing shoulder
subluxation. This type of injury is common in contact sports specifically boxing.
Excessive shoulder joint movement is not recommended for shoulder subluxation
as vigorous movement generates stress in the joint which also cause shoulder
subluxation.
HOW TO ASSESS SHOULDER SUBLUXATION:
• Use fingers to measure the grade of the subluxation by placing it below the
bony prominence on the lateral side of your shoulder without any support
on the arm.
GRADES OF SUBLUXATION:
• 0 - no subluxation
• 1 - ½ fingerbreadth gap
• 2 - 1 fingerbreadth gap
• 3 - 1 ½ fingerbreadth gap
• 4 - 2 fingerbreadth gap
• 5 - 2 ½ fingerbreadth gap
TYPES OF SUBLUXATION:
• Vertebral Subluxation
A vertebral subluxation can occur from poor posture, repetitive movements, or
trauma to the spine, such as a fall or severe blow. The subluxation may involve a
ligament rupture with or without injury to the vertebra (spinal bones) itself. This type
of injury can compress the spinal cord, resulting in shooting pains or loss of nerve
function.
• Subluxation of the Shoulder
A subluxation of the shoulder means that the ball of your upper arm comes partially
out of the socket in your scapula (shoulder blade). Severe injury or trauma is most
often the cause of shoulder subluxation.
Sports like swimming, tennis, volleyball, and others that involve repetitive upward
motions can loosen the ligaments in the shoulder and make it more likely for
subluxation to occur.
With shoulder subluxation, your shoulder may feel as it is loose or slipping in and out
of the socket. Pain and loss of motion are common and often extreme.
• Subluxation of the Patella
The patella (kneecaps) fits in a groove at the end of the tibia (thigh bone). A subluxation of
the patella occurs when the kneecap moves partially out of that groove. Patellar subluxation
is the most common knee problem in children and adolescents.
A joint subluxation of the knee is usually caused by a direct fall on the knee but can also
happen if the knee ligaments are loose. Symptoms can vary but may include pain, swelling,
feeling the knee "give way," and a misshapen look to the knee.
• Elbow Subluxation
Elbow subluxations can occur when someone falls onto their hands. Though elbow
luxation's are typically very painful, subluxations may not be as obvious. The elbow may
move perfectly well, although there may be a dull or sharp pain.
Children under seven can get a type of subluxation called a radial head subluxation. This
can happen when the child’s arm is pulled a little too roughly. Because the bones and
muscles of younger children are still growing, dislocation can occur quite easily.
CAUSES OF SUBLUXATION:
• Accidents
• Falls
• Sports injury
• Birth stress
• Bad posture
• And other trauma causes subluxation.
Symptoms:
• Nocturnal and early morning pain increment
• Throbbing sensation at the shoulder joint.
• Restricted shoulder movement
• Shoulder muscles become much early fatigue than the previous
• Weakness at the shoulder joint
• Inflammation at the shoulder
• Bones of shoulder joint protruded.
• Lying down at the side of affected shoulder cause pain increment
• In severe case total cessation of hand movement
• Incidence is reappear frequently in severe case.
TREATMENT:
HAND POSITIONING
• Correct positioning at an early stage can promote body awareness, prevent shoulder
subluxation and reduce tone spasticity.
• After examining the injury, reset the joint into its proper position using manual manipulation.
This may involve turning or pulling the limb.
• Once the joint is properly realigned the treatment will be focused on reducing inflammation and
pain. The standard approach, know as RICE, involves:
• Rest: limit activity and avoid putting weight on the affected joint. To improve recovery and
ensure stability, immobilize the joint with a splint, brace, or cast.
• Ice application: Icing an injury, helps dilate blood vessels to reduce pain, inflammation, and
swelling. Apply the ice pack for no more than 15 to 20 minutes several times a day, using a
cloth barrier to prevent frostbite.
• Compression: an elastic bandage to control swelling, reduce blood flow, and provide structural
support to the affected joint.
• Elevation: Placing the joint above the heart can also alleviate pain and inflammation by
reducing blood flow and pressure to the joint.
BRACES FOR SHOULDER
SUBLUXATION: