What is shoulder dislocation?
The shoulder joint is a ball and socket joint. The ball is a part of the long arm bone which is quite large in comparison to the socket. Therefore making it a very mobile but unstable joint. When the shoulder joint is dislocated it occurs when the ball is forcibly separated from the socket. When this happens the muscles, ligaments and tendons can be stretched and torn. Sometimes the ball will go back into the socket itself however sometimes the joint needs to be relocated in the emergency department.
Signs and symptoms
- Sever pain down the arm
- Obvious deformity of the shoulder
- Inability to move the arm
- In some cases you may feel numbness of the arm
You will need an X-ray to determine the position of your humeral head relative to the socket and to determine if there is also a fracture. A first-time shoulder dislocation will often need to be treated in the emergency department of the hospital.
What causes shoulder dislocation?
Most commonly shoulder dislocations are caused by a trauma to the shoulder whether it is a direct blow for example in a rugby tackle or by falling on an outstretched hand. Some people do have hypermobile joints and can be more prone to dislocations or partial dislocations called subluxations.
Conservative treatment
Once having your shoulder relocated in ED you will likely need an xray to determine that there is no fracture. Once the shoulder has been relocated the shoulder is not fixed you will need ongoing rehabilitation with a physiotherapist. Rehabilitation will include:
- Strength and range exercises. The first step is to restore full range of movement. Then the physiotherapist will start you on some exercises on the rotator cuff muscles, which provide stability to the shoulder joint. An important aspect to the physiotherapy rehabilitation in shoulder dislocations is restoring muscular control of the shoulder joint so you can prevent future dislocations.
- Taping/ bracing. The shoulder will then need to be immobilized or taped for a period of time to provide support to the soft tissues that have been stretched.
- Activity modification. avoiding overhead activity and heavy lifting is recommended while the tissue heals.
- Ice & Anti-inflammatory. Ice and anti-inflammatories can help with acute management. Non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, naproxen, or aspirin, will help with pain and swelling as per GP instructions.
Surgery
Surgery for shoulder dislocation may be indicated if patients are unable or unwilling to change their occupation or avoid participating in high-risk sports and if they have recurrent dislocations or subluxations. Surgery may also be appropriate in individuals who have recurrent dislocations.
