ZocdocAnswersHow do you know when physical therapy has failed you?

Question

How do you know when physical therapy has failed you?

I was prescribed 6 weeks of PT 2 times a week. The purpose was to stabilize my shoulder not necessarily completely rehabilitate it. My shoulder has been dislocating over 20 times a day both posterior and anterior.When I started physical therapy it was only popping out posterior and not anterior. By the third visit it had started popping out anterior. The first two visits went as well as they could but by the third visit everything went awry. My shoulder was popping out with every exercise. The next visit they were able to manually stabilize my shoulder so I could do physical therapy. I had a week off for at home PT. I came back for another appointment and did a reevaluation and my shoulder was much looser and not stronger and still needed manual stabilization during and couldn't perform it without stabilization. The last visit my therapist tried to tape my shoulder to keep it in.It didn't work and my shoulder was still dislocating and more unstable. She thought I needed surgery.

Answer

You are right that, in this situation, the purpose of physical therapy is to help strengthen the muscles around the shoulder and, hopefully, reduce the risk that the shoulder will dislocate once again. It sounds like this has not happened for you despite good adherence to the prescribed physical therapy regimen. On the other hand, it is also true that many people do not see benefits from physical therapy until they have been performing the exercises for at least 6 months, so it may be that you just need to continue with the physical therapy for longer. However, as a first step, I would suggest that you make a follow-up appointment with the doctor who prescribed the physical therapy for you in the first place, so that you can discuss your current level of symptoms and decide what to do next. Together, you might decide that continued or intensified physical therapy is still the way to go. On the other hand, especially if there is significant pain in the shoulder, it might be necessary to seek a referral to an orthopedic surgeon, who will be able to decide whether or not a surgical repair might be on the table. Good luck!

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