Shoulder Dislocation.

Have you suffered from a shoulder dislocation recently? A man came came into my practice recently after dislocating his shoulder three times over the previous 12 months.

The first time it happened it occurred as a result of a major trauma, where a heavy weight forced his shoulder to pop out! The second time was more surprising for him, as he simply reached back in the car to pick up his laptop. More recently, the third time shocked him, as he was reaching back for his safety belt when he dislocated his shoulder.

Unfortunately, shoulder dislocation is a fairly common presentation in my physiotherapy practice. The frequent mistake people make is not having it assessed and rehabilitated by a physiotherapist after the first dislocation! Let me explain!

First- What is a Dislocated Shoulder?
Shoulder dislocation occurs when the humerus moves excessively away from the scapula at the gleno-humeral joint. The humerus is the long bone of your upper arm. The top of your humerus has a ball of bone. This ball of bone moves away from the glenoid of the scapula in a shoulder dislocation. The glenoid bone is the surface of the scapula that forms the shoulder joint with the humerus.

Put simply, the shoulder joint is a ball and socket joint. However it is different to the hip, which is also a ball and socket joint, in that the shoulder socket is very shallow and therefore more pre-disposed to dislocation.

The shoulder joint has the largest range of motion of all the joints in the body. It is as a result of this that the shoulder is particularly susceptible to dislocation and subluxation (a partial dislocation of the shoulder is referred to as a subluxation). In truth 70% of the major joint dislocations that I see are of the shoulder joint. After the shoulder comes patella-femoral dislocations - a dislocation of your knee cap!

dislocated shoulder

Another reason why the shoulder joint is the most commonly dislocated joint in the body is because it moves in many directions and as a result your shoulder can dislocate forward, backward or downwards, completely or partially. If you dislocate your shoulder you may also damage ligaments and nerves and this can make your rehabilitation more difficult.

The mechanics of your shoulder dislocating involves a strong force, such as a sudden strong blow to your shoulder. This pulls the bones in your shoulder out of place often resulting in dislocation.

Another common cause of shoulder dislocation can result from an extreme rotation of your shoulder joint. This excessive rotation can dislocate the ball of your upper arm bone (humerus) out of your shoulder socket (glenoid). Partial dislocation, also known as subluxation, is where your humerus is partially in and partially out of your shoulder socket. Both situations are quite nasty!!!!

What causes a Shoulder Dislocation?

Sports injuries. Shoulder dislocation is a common injury in all contact sports. I frequently see shoulder dislocations in football, hockey, ski-ing and gymnastics. However, all contact sports potentially leave you prone to shoulder dislocations.

Trauma. A hard blow to your shoulder can always be a cause of shoulder dislocation. This trauma can occur in sport or from an accident such as a road traffic accident.

Falls. You may dislocate your shoulder during, or at the end of, a fall. A common example I see in my practice is following a fall from a ladder or horse!

Only recently I saw a dislocated shoulder occurring as a result of a patient tripping over a rug on her own kitchen floor!

What are the Symptoms of a Dislocated Shoulder?
Dislocated shoulder signs and symptoms usually include:

An obviously deformed or out of place shoulder

Swelling and bruising

Extreme pain

Inability to move the joint

Shoulder dislocation can also cause numbness, weakness or tingling in the arm. This is due to the affected bones and muscles compressing nerves in this area. The muscles around your shoulder often go into spasm, which will then increase the intensity of your pain.

What is the advised Treatment for a Dislocated Shoulder?

See a doctor! Ideally go to a hospital where the doctors have experience in relocating dislocated shoulder joints. I have relocated two on the sports field and trust me it is no easy job for the patient or the therapist!!

Do not move the joint until an experienced medical person is present.

Ice it!

Subsequent physiotherapy to reduce inflammation to torn ligaments and to strengthen muscles to prevent further dislocations.

Unfortunately I have seen too many repeat shoulder dislocations. From my experience if you rehabilitate your shoulder back to full strength and stability after the first incident - re-occurrence is less likely. However, if you donÂ’t it is highly possible that it will re-occur.

I often compare repeat dislocations to overstretching a jumper! If you stretch a jumper out of shape once it will usually return to its original shape after a good wash! However, if you stretch it repetitively it will eventually take the shape that you stretch it too in a more permanent manner!

Similarly for the shoulder - if it is overstretched through dislocation more than once and not repaired properly it will remain loose like the stretched jumper and will be prone to falling out of its socket more easily! The end result is repeat dislocations! Ouch!!

So, seek early intervention and if you have a dislocated shoulder and follow up with an experienced physiotherapist/physical therapist so as to reduce the risks of this painful event from re-occurring.

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Further References:

Chronic Shoulder Pain
Shoulder Joint Pain
Neck Shoulder Arm Pain
Shoulder Arthritis
Left Vs. Right Shoulder Pain
Frozen Shoulder Treatment
Shoulder Rehab Exercises
Shoulder Anatomy
Shoulder Surgery Recovery
Shoulder Tendonitis

Return from Shoulder Dislocation to Shoulder Pain Relief

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