Shoulder Dislocation: What You Need to Know About Diagnosis and Treatment

A shoulder dislocation occurs when the head of the humerus (upper arm bone) is forced out of the glenoid cavity (shoulder socket). This is a common injury in sports, falls, and accidents and can cause significant pain, instability, and long-term complications if not treated properly. This article explains the causes, symptoms, diagnosis, and treatment options for shoulder dislocations to help patients understand the steps to recovery.

Jump ahead to:

What Is a Shoulder Dislocation?

The shoulder is a ball-and-socket joint that allows a wide range of motion. However, this flexibility also makes the shoulder susceptible to dislocations. In a shoulder dislocation, the humeral head is displaced from the glenoid cavity, causing damage to the surrounding ligaments, tendons, and joint capsule.

Types of Shoulder Dislocations

There are different types of shoulder dislocations based on the direction of displacement:

Anterior Dislocation: The most common type is where the humeral head is displaced forward out of the socket. It typically occurs due to a fall on an outstretched arm or a forceful blow to the shoulder.
Posterior Dislocation: Less joint, occurring when the humeral head is forced backward. It can result from a direct blow to the front of the shoulder or a seizure.
Inferior Dislocation: Rare, occurring when the humeral head is displaced downward. It often results from forcefully pulling the arm away from the body.

Causes of Shoulder Dislocation

Sports Injuries: Contact sports, such as football, rugby, and hockey, and activities involving overhead motions, like swimming and tennis, increase the risk of shoulder dislocations.
Falls: Falling on an outstretched arm or directly onto the shoulder can dislocate the joint.
Trauma: Car accidents or direct blows to the shoulder can force the humeral head out of the socket.
Previous Dislocations: A history of shoulder dislocations increases the risk of recurrence, as the joint may become unstable.

Symptoms of Shoulder Dislocation

Intense Pain: Sudden, severe shoulder pain at the time of injury.
Visible Deformity: The shoulder may appear visibly out of place, with a noticeable bulge at the front or back of the joint.
Limited Movement: Inability to move the arm, particularly in lifting or rotating motions.
Swelling and Bruising: Swelling, bruising, and tenderness around the shoulder joint.
Numbness or Tingling: Numbness or tingling in the arm or hand may indicate nerve involvement.

Diagnosing Shoulder Dislocation

A prompt and accurate diagnosis is crucial for appropriate treatment:

1. Physical Examination

The doctor will assess the shoulder’s position, range of motion, and areas of tenderness. They will also check for signs of nerve or blood vessel involvement, such as numbness, tingling, or weak pulse in the arm.

2. Imaging Studies

X-rays: X-rays confirm the dislocation, identify the direction of displacement, and check for fractures or other bone abnormalities.
MRI: Magnetic resonance imaging (MRI) may be ordered to evaluate soft tissue damage, such as ligament tears, labral tears, or rotator cuff injuries.

Treatment Options for Shoulder Dislocation

1. Closed Reduction

Closed reduction is a non-surgical procedure in which the doctor gently manipulates the arm to guide the humeral head back into the socket. To minimize pain, this procedure is usually performed under local anesthesia or sedation.

Post-Reduction Care: After the shoulder is relocated, the doctor may immobilize the arm in a sling or brace for several weeks to allow the ligaments and joint capsule to heal.

2. Medications

Pain Relief: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage pain during recovery.
Muscle Relaxants: In some cases, muscle relaxants may be prescribed to reduce muscle spasms associated with shoulder dislocation.

3. Physical Therapy

Physical therapy is essential for restoring shoulder strength, flexibility, and stability after a dislocation. A physical therapist will guide the patient through exercises that focus on:

Range of Motion: Gentle stretching exercises to prevent stiffness and maintain joint mobility.
Strengthening: Strengthening the rotator cuff and scapular stabilizer muscles to enhance shoulder stability and reduce the risk of future dislocations.
Posture and Mechanics: Educating patients on proper posture and movement patterns to protect the shoulder joint.

4. Surgical Intervention

Surgery may be necessary for patients with recurrent dislocations, significant soft tissue damage, or structural abnormalities. Surgical options include:

Labral Repair: Arthroscopic surgery to repair a torn labrum, particularly in Bankart lesions associated with anterior dislocations.
Ligament Reconstruction: Tightening or reconstructing the ligaments to restore shoulder stability.
Latarjet Procedure: Bone grafting surgery to increase the size of the glenoid cavity and prevent recurrent dislocations.

Recovery After Shoulder Dislocation

Immobilization: After closed reduction, the shoulder is typically immobilized in a sling for 2-4 weeks to allow the tissues to heal.
Rehabilitation: Physical therapy plays a crucial role in the recovery process, focusing on restoring range of motion, strength, and joint stability.
Gradual Return to Activities: Patients should gradually resume physical activities and avoid high-risk movements until cleared by their orthopedic specialist.

Preventing Recurrent Shoulder Dislocations

Strengthening Exercises: Regularly perform shoulder-strengthening exercises to enhance joint stability.
Proper Technique: Use appropriate techniques during sports and physical activities to minimize the risk of dislocation.
Protective Gear: Wear appropriate protective gear like shoulder pads when participating in contact sports.

Conclusion

Shoulder dislocation is a common injury requiring prompt treatment to restore joint stability and prevent complications. With proper diagnosis, closed reduction, physical therapy, and, if necessary, surgical intervention, patients can achieve a full recovery and return to their activities. For recurrent shoulder dislocations or persistent instability, consult an orthopedic specialist to discuss the best treatment options for long-term shoulder health.