cunningham technique/shoulder dislocation

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not sure why a musculoskeletal dislocation problem fixed with the help of manual muscle relaxation is all that different from one fixed with the help of chemical muscle relaxation. sounds worth a try, not a smirk.
 
I did it last week on a morbidly obese guy with COPD we didn't want to sedate--it worked phenomenally!

The key was to have him sitting upright and then gently (very gently) applying downward traction with your left arm (if pt has L shoulder dislocation) and then deep massage from neck-shoulder-biceps with your right hand.

Once I got over my uncomfortableness about massaging a dude, the procedure went smooth.

Took 90 sec until relocation with no pain meds or sedation and the pt was completely comfortable.
 
One of my colleagues used this to discharge a pt from the waiting room on a day when we were log-jammed. I'll definitely try it in my next cooperative shoulder dislocation patient.
 
I've wanted this to work so badly... but I'm 1/4 currently (and I was patient! and I relaxed the patient! and I massaged them! Maybe I should have played relaxing music?)

Anyway, my current favored technique is a modified kocher from the seated position:
http://shoulderdislocation.net/relocation/kochers

I like to make the patient anteriorly flex the shoulder much more than they show in step 3. Otherwise pretty much like the above slides show. If this fails (I generally have them seated, mildly sedated) I advance the sedation and lay them down, and move to ext. rotation and then traction-counter-traction..

Also, this video has some great tips:
http://www.youtube.com/watch?v=8xibzOM7Hp0
 
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