DISLOKASI BAHU
Kompetensi 2
Gejala Klinis
Dislokasi Anterior
Epidemiologi Lebih sering (90% kasus)
 Abduksi, rotasi eksternal, dan
ekstensi yang berlebihan
Mekanisme
 Pukulan keras pada humerus saat
posisi abduksi
 Lengan dalam posisi sedikit abduksi
dan rotasi eksternal
 Caput humeri teraba di bawah
Gejala Klinis
processus coracoideus
 Depresi di bawah acromion
 Bahu tampak datar
Apprehension test
 Pasien duduk atau berbaring
 Abduksi bahu 900  Fleksi siku 
Rotasi eksternal bahu maksimal
 Tangan yang lain sambil menekan
bagian posterior caput humeri
 Positif apabila pasien merasa
khawatir (apprehension) akan terjadi
Tes Provokasi
dislokasi bahu
Dislokasi Posterior
Jarang
 Adduksi dan rotasi internal yang
berlebihan
 Jatuh dalam posisi tangan terulur
(outstretched hand)
 Pukulan pada bagian depan bahu
 Lengan dalam posisi sedikit adduksi
dan rotasi internal
 Caput humeri teraba di posterior
 Depresi di bawah acromion
 Bahu tampak datar
 Processus coracoideus prominen
Jerk test
 Pasien duduk
 Abduksi bahu 900  Fleksi siku 
Rotasi internal bahu  Adduksi bahu
secara horizontal
 Tangan yang lain sambil
menstabilkan scapula
 Positif apabila pasien merasa nyeri
mendadak (sudden jerk)
Gambaran Radiologi
Dislokasi Anterior Dislokasi Posterior
 Light bulb sign karena rotasi
internal dari caput humeri
 Celah articulatio humeri > 6 mm
 Garis Trough yaitu 2 garis paralel di

Caput humeri terdapat di bagian bagian media caput humeri

medial dan inferior processus

coracoideus

AP View

Caput humeri terdapat di bagian Caput humeri terdapat di bagian

anterior cavitas glenoidalis posterior cavitas glenoidalis

Axial View
 Caput humeri terdapat di bagian Caput humeri terdapat di bagian
medial Y posterior Y

Transcapular View

Therapy
1. Phase 1 (Acute) with PRICE for About 1 – 2 Days
P Protection Arm should be immobilized in shoulder sling for 1 – 3 weeks
R Rest Rest from all activities that cause shoulder pain
I Ice  Place an ice bag on the shoulder for 15 – 20 minutes, 3 – 5 times per day
for the first 24 – 72 hours
 After 72 hours, apply ice bag after exercise or activity
C Compression Wear shoulder sling
E Elevation -

2. Phase 2 (Subacute) with Active and Passive ROM for 2 – 7 Days

a. Passive ROM
Pendulum Exercise
 Bend forward 900 at the waist, placing your
uninvolved hand on table for support
 Rock body in circular pattern to move arm
clockwise 10 times, then counterclockwise 10
times. Keep your arm relaxed during the
exercise. The circular pendular movement
should occur through your shoulder joint
 Do 3 sessions per day
 Assisted Elevation
 This exercise can be done either lying down or
sitting down
 Clasp hands together and lift arms above
head. Keep your elbows as straight as
possible. Maintain the elevation for 10 – 20
seconds then slowly lower your arms
 Slowly increase the elevation of your arms as
the days progress, using pain as your guide
 Repeat 10 – 20 times per session
 Do 3 sessions per day
Supported Shoulder Rotation
 Keep elbow in place and shoulder blades
down and together. Slide forearm back and
forth. You can also perform this exercise using
a stick or cane to assist your arm outwards
 Repeat 10 times per session
 Do 3 sessions per day

Shoulder Internal Rotation

 Use your other hand or towel to help bring
your involved hand behind your back and
across to the opposite side
 Repeat 10 times per session
 Do 3 sessions per day

b. Active ROM

Finger Ladder
 With elbow straight, use fingers to crawl up
the wall or door frame as far as possible. Hold
for 10 – 20 seconds
 Repeat 5 – 10 times per session
 Do 3 sessions per day
 Shoulder Forward Elevation
 Raise arm upward to point to ceiling, keeping
the elbows straight and leading with your
thumb. Hold for 10 seconds
 Repeat 3 times per session
 Do 3 sessions per day

Shoulder Abduction
 Raise arm out to side, with elbow straight and
palm downward. Do not shrug your shoulder
or tilt your trunk
 Repeat 3 times per session
 Do 3 sessions per day

3. Phase 3 (Re-conditioning) with Stretching and Strengthening Exercise for 1 – 3 Weeks

a. Isometric Exercise

Shoulder Extension
 Stand with your back against the wall and
arms straight at your sides. Keeping your
elbows straight, push your arms back into the
wall. Hold for 5 seconds, and then relax
 Repeat 5 – 10 times per session
 Do 3 sessions per day
Shoulder External Rotation
 Stand with the involved side of your body
against a wall. Bend your elbow 900. Push the
back of your hand slowly into the wall. Hold
for 5 seconds, and then relax
 Repeat 10 times per session
 Do 3 sessions per day

Shoulder Internal Rotation

 Stand at corner of wall or in door frame. Place
your involved arm against the wall around the
corner, bending your elbow 900. Push the
palm of your hand into the wall. Hold for 5
seconds, and then relax
 Repeat 10 times per session
 Do 3 sessions per day

Shoulder Adduction
 Place small pillow between your inner arm
and the side of your chest. With your arm,
squeeze the pillow against the side of your
chest. Hold for 5 seconds, and then relax
 Repeat 10 times per session
 Do 3 sessions per day

Shoulder Abduction
 Resisting upward motion to the side, slowly
and gently push your arm against the back of
chair. Hold for 5 seconds, and then relax
 Repeat 10 times per session
 Do 3 sessions per day
b. Theraband Exercise
All of these exercise is repeated each one 20 times, 3 times daily. If possible, hold each exercise
for 3 – 5 seconds at the end of the movement then let your arm return slowly

Shoulder Flexion
Grip theraband in front of you with the elbow
extended. Pull theraband upward until maximal
range of motion is reached and lower downward

Shoulder Extension
Start in same position as flexion. Pull theraband
backward until maximal range of motion is
reached and bring back to starting position

Shoulder Internal Rotation

Stand in front of theraband board with affected
arm facing it. Rotate arm inward across body
while gripping the unattached end of theraband
 Shoulder External Rotation
Stand in front of theraband board with
unaffected arm facing it. Rotate arm outward
away from the body while gripping the
unattached end of theraband

Shoulder Adduction
Stand sideways next to door with affected arm
facing itu. Grab the theraband and pull arm
toward the buttocks

c. Open Kinetic Exercise

Shoulder External Rotation

 Lie on your uninvolved side. Keep your elbow
bent at 900. Holding a light weight, raise hand
away from stomach. Slowly return
 Repeat 10 times per session
 Do 3 sessions per day

Shoulder Internal Rotation

 Lie on your involved side. Keep your elbow
bent at 900. Holding a light weight, raise hand
toward stomach. Slowly return
 Repeat 10 times per session
 Do 3 sessions per day
4. Phase 4 (Conditioning) with Specific Exercise for About 14 Days
Perform all exercise with minimal or no pain
 Baseball or softball : Perform overhand throwing
 Football : Throw spiral, catch a throw (depending on position)
 Volleyball or tennis : Perform a serve
 Basketball : Practive shooting and passing drills