The shoulder is the body’s most mobile joint, which makes it susceptible to dislocation. A dislocated shoulder is an injury in which your upper arm bone pops out of the cup-shaped socket that’s part of your shoulder blade. If you suspect a dislocated shoulder , seek prompt medical attention. Most people regain full shoulder function within a few weeks. However, once you’ve had a dislocated shoulder, your joint may become unstable and be prone to repeat dislocations.
Symptoms of Acute shoulder dislocation
● A visibly deformed or out-of-place shoulder
● Swelling or bruising
● Intense pain
● Inability to move the joint
Shoulder dislocation may also cause numbness, weakness or tingling near the injury, such as in your neck or down your arm. The muscles in your shoulder may spasm from the disruption, often increasing the intensity of your pain.
Symptoms of Chronic shoulder instability
● Pain caused by shoulder injury
● Repeated shoulder dislocations
● Repeated instances of the shoulder giving out
● A persistent sensation of the shoulder feeling loose, slipping in and out of the joint.
When to see a doctor?
Get medical help right away for a shoulder that appears dislocated.
While you’re waiting for medical attention:
● Don’t move the joint. Splint or sling the shoulder joint in its current position. Don’t try to move the shoulder or force it back into place. This can damage the shoulder joint and its surrounding muscles, ligaments, nerves or blood vessels.
● Ice the injured joint. Applying ice to your shoulder can help reduce pain and swelling by controlling internal bleeding and the buildup of fluids in and around your shoulder joint.
The shoulder joint is the most frequently dislocated joint of the body. Because it moves in several directions, your shoulder can dislocate forward, backward or downward, completely or partially, though most dislocations occur through the front of the shoulder. In addition, fibrous tissue that joins the bones of your shoulder can be stretched or torn, often complicating the dislocation. It takes a strong force, such as a sudden blow to your shoulder, to pull the bones out of place. Extreme rotation of your shoulder joint can pop the ball of your upper arm bone out of your shoulder socket. Partial dislocation in which your upper arm bone is partially in and partially out of your shoulder socket — also may occur.
A dislocated shoulder may be caused by:
● Sports injuries: Shoulder dislocation is a common injury in contact sports, such as cricket, football and hockey, and in sports that may involve falls, such as downhill skiing, gymnastics and volleyball.
● Trauma not related to sports: A hard blow to your shoulder during a motor vehicle accident is a common source of dislocation.
● Falls: You may dislocate your shoulder during a fall, such as from a ladder or from
tripping on a loose rug. When the head of the humerus dislocates, the socket bone (glenoid) and the ligaments in the front of the shoulder are often injured. The labrum — the cartilage rim around the edge of the glenoid — may also tear. This is commonly called a Bankart lesion. A severe first dislocation can lead to continued dislocations, giving out, or a feeling of instability.
● Repetitive Strain: Some people with shoulder instability have never had a dislocation. Most of these patients have loose ligaments in their shoulders. This increased looseness is sometimes just their normal anatomy. Sometimes, it is the result of repetitive overhead motion.
● Multi-directional Instability: In a small minority of patients, the shoulder can become unstable without a history of injury or repetitive strain. In such patients, the shoulder may feel loose or dislocate in multiple directions, meaning the ball may dislocate out the front, out the back, or out the bottom of the shoulder. This is called multidirectional instability. These patients have naturally loose ligaments throughout the body and may be “double-jointed”.
Males in their teens or twenty’s, a group that tends to be physically active, are at highest risk of shoulder dislocation.
Complications of a dislocated shoulder may include:
● Tearing of the muscles, ligaments and tendons that reinforce your shoulder joint
● Nerve or blood vessel damage in or around your shoulder joint
● Shoulder instability, especially if you have a severe dislocation or repeated dislocations,
which makes you more prone to re-injury.
If you stretch or tear ligaments or tendons in your shoulder or damage nerves or blood vessels around your shoulder joint, you may need surgery to repair these tissues.
● Take care to avoid falls
● Wear protective gear when you play contact sports
● Exercise regularly to maintain strength and flexibility in your joints and muscles
Once you’ve dislocated your shoulder joint, you may be more susceptible to future shoulder dislocations. To avoid a recurrence, follow the specific strength and stability exercises that you and your doctor have discussed for your injury.
Physical Examination and Patient History: After discussing your symptoms and medical history, your doctor will examine your shoulder. Specific tests help your doctor assess instability in your shoulder. Your doctor may also test for general looseness in your ligaments.
Imaging Tests: Your doctor may order imaging tests to help confirm your diagnosis and identify any other problems.
X-rays: These pictures will show any injuries to the bones that make up your shoulder joint.
Magnetic resonance imaging (MRI): This provides detailed images of soft tissues. It may help your doctor identify injuries to the ligaments and tendons surrounding your shoulder joint.
Dislocated shoulder treatment may involve:
● Closed reduction: Your doctor may try some gentle maneuvers to help your shoulder bones back into their proper positions. Depending on the amount of pain and swelling, you may need a muscle relaxant or sedative or, rarely, a general anesthetic before manipulation of your shoulder bones. When your shoulder bones are back in place, severe pain should improve almost immediately.
● Surgery: You may need surgery if you have a weak shoulder joint or ligaments and tend to have recurring shoulder dislocations despite proper strengthening and rehabilitation. In rare cases, you may need surgery if your nerves or blood vessels are damaged.
● Arthroscopy: Soft tissues in the shoulder can be repaired using tiny instruments and small incisions. This is a same-day or outpatient procedure. Arthroscopy is a minimally invasive surgery. Your surgeon will look inside the shoulder with a tiny camera and perform the surgery with special pencil-thin instruments.
● Open Surgery: Some patients may need an open surgical procedure. This involves making a larger incision over the shoulder and performing the repair under direct visualization.
● Immobilization: Your doctor may use a special splint or sling for a few days to three weeks to keep your shoulder from moving. How long you wear the splint or sling depends on the nature of your shoulder dislocation and how soon the splint is applied after your dislocation.
● Medication: Your doctor might prescribe a pain reliever or a muscle relaxant to keep you comfortable while your shoulder heals.
● Rehabilitation. After your shoulder splint or sling is removed, you’ll begin a gradual rehabilitation program designed to restore range of motion, strength and stability to your shoulder joint.
If you have a fairly simple shoulder dislocation without major nerve or tissue damage, your shoulder joint likely will improve over a few weeks, but you’ll be at increased risk for future dislocation. Resuming activity too soon after shoulder dislocation may cause you to injure your shoulder joint or to dislocate it again.
Lifestyle and home remedies
Try these steps to help ease discomfort and encourage healing after being treated for a
● Rest your shoulder- Don’t repeat the specific action that caused your shoulder to dislocate, and try to avoid painful movements. Limit heavy lifting or overhead activity until your shoulder feels better.
● Apply ice – Putting ice on your shoulder helps reduce inflammation and pain. Use a cold pack or a towel filled with ice cubes for 15 to 20 minutes at a time. Do this every couple of hours the first few days.
● Take pain killers as and when required as prescribed by your doctor.
● Maintain the range of motion of your shoulder- After one or two days, do some gentle exercises as directed by your doctor or physical therapist to help maintain your shoulder’s range of motion. Inactivity can cause stiff joints.
Be sure to follow your doctor’s treatment plan. Although it is a slow process, your commitment to physical therapy is the most important factor in returning to all the activities you enjoy.Read More