Dislocated Shoulder

A shoulder dislocation is an injury to the shoulder in which the upper arm bone pops out of its socket in the shoulder blade. The shoulder is the most mobile joint in the body. This increases the risk of developing dislocations.

Immediate medical attention is required for shoulder dislocations. Most people tend to develop full shoulder function within a few weeks. People with a history of shoulder dislocations are at an increased risk of developing future shoulder dislocations due to instability of the joint.

The symptoms of shoulder dislocation include:

• A visibly deformed shoulder
• Swelling and bruising
• Intense pain
• Inability to move the shoulder
• Numbness, tingling or weakness in the area around the shoulder,such as the neck and upper arm
• Spasm of the muscles of the shoulder due to intense pain

The causes of shoulder dislocation include:

• a sudden blow to the shoulder which pulls the bones of the shoulder out of place
• extreme rotation of the shoulder which may cause the shoulder to pop out of it's socket.

Shoulder dislocations can occur during sport injuries, trauma not related to sports, such as motor vehicle accidents and falls.

The shoulder joint is the most mobile joint in the body. The shoulder can dislocate forward, backward or downwards with most cases being through the front of the shoulder.

Shoulder dislocations can also be partial or complete. A partial dislocation is one in which the bone of the upper arm (humerus) is partially in and out of it's socket. Damage to the ligaments that hold the joint in place can be stretched or torn. This can complicated the injury.

A physical exam in which doctors inspect the shoulder to look for swelling or deformity and an X-ray of the shoulder can be used to diagnose a dislocated shoulder. X-ray of the shoulder also helps doctors to look for broken bones or damage to other structures around the shoulder joint.

Treatments for dislocated shoulder include:

• Closed reduction- a procedure in which the bones shoulder joint are placed back into place. Patients may be given a muscle relaxant, sedative or general anaesthesia depending on the intensity of pain and swelling. Placing the shoulder joint back in place helps to reduce pain.
• Surgery in cases where a patient has a weak shoulder joint, ligaments or tendons or when there is damage of vessels or nerves near the shoulder joint.
• Immobilization of the shoulder joint with a special splint or sling for a few days to a few weeks depending on the extent of injury, to prevent the shoulder from moving. Pain killers of muscle relaxants to help the patient deal with pain or muscle spasms while the shoulder heals.
• Rehabilitation after the shoulder has healed to restore shoulder motion,strength and stability. Mild cases of shoulder dislocations usually develop within a few weeks.

Shoulder dislocations can be prevented by:

• avoiding falls,
• wearing protective gear during contact sports
• regular exercise to maintain strength and flexibility in the joints and muscles.

Patients with a history of shoulder dislocations can avoid future dislocations by following specific strength and stability exercises for the shoulder joint.

There are different ways to adapt your lifestyle in coping with dislocated shoulder.

The following can help to reduce discomfort and encourage healing of a dislocated shoulder:

• Resting the shoulder and avoiding tasks that can cause more damage to the shoulder.
• Applying ice then heat to the shoulder to reduce inflammation and pain.Ice can be used within the first two days while heat can be applied after two to three days to relax tight and sore muscles. Heat should not be applied for more than 20 minutes at a time.
• Taking over-the-counter pain medication such as ibuprofen (Advil, Motrin IB) and acetaminophen (Tylenol).
• Maintaining the range of motion in the shoulder through some gentle exercises. Inactivity can make the joint stiff and can lead to a frozen shoulder, a condition in which the joint is so stiff that it can hardly move.
• After the shoulder has healed, daily exercises are necessary to ensure restoration of full motion, strength and stability of the joint.

Males in their teens or 20s are at an increased risk of developing shoulder dislocations. This is due to increased physical activity. Complications of shoulder dislocations include:

• Tearing of muscles, tendons and ligaments that keep the shoulder in place
• Damge to the nerves or blood vessels around the shoulder joint
• Instabiliity of the shoulder joint which increases the risk of future dislocations