Recently I have been working with a high school baseball player who dislocated his non-throwing arm while playing basketball.  He suffered a typical anterior/inferior dislocation, was placed in a sling for a couple weeks, and then came to see me after checking in with his doc.

He had near full AROM when starting, so manual treatment was only needed to clean up his end range of motion.  We progressed with rhythmic stabilizations in multiple planes to get some controlled cuff work in.  I like to stress keeping the arm centered in the socket and watch for thoracolumbar junction hyperextension.  But really what I care about is that the movements pass the eye test and the kid verifies that the arm feels good.  Athletes usually know their body, and if they trust you they will give great information during this portion of the rehab.  

Here is the part I want to share.  He quickly needed to build resiliency of his tissues and improve strength from the ground up to the shoulder.  Here are some of his progressions within our treatment process.  

Dumbbell bent row > Dumbbell bent row with iso hold > Bent row with perturbations > TRX inverted rows

Supine protraction with rhythmic stabs > Kettlebell arm bar > Bottoms up kettlebell arm bar > 1/2 kneeling landmine press

Hand switches from pushup position > Band resisted hand switches > Step walkovers > Pushups

This is an example of how I progress pulling, pushing, and closed chain work in overhead athletes.  Static moves to dynamic, supine moves to kneeling to standing, and single plane moves to multi-planar.  He was seen for 7 visits over a 3 week period and discharged to a gym program (shocker, it looks just like his rehab program at this point).  “Traditional” rehab would likely treat for 12-18 visits and never progress beyond an upper body erg, scapular strengthening in prone and wall push ups.  

Not only is this more cost and time effective, but it prepares kids for return to sport and the weight room.  Plus they transition back to sport a lot stronger, have better body awareness and return to throwing the hell out a baseball!