A shoulder dislocation occurs when the upper arm bone (humerus) is forced out of its natural position in the shoulder socket (glenoid). This injury often results from accidents or physical activities, leading to pain, limited movement, and possible complications if not addressed properly. This guide explores the causes, symptoms, and treatment options to provide a clear understanding of the condition.
What Happens During a Shoulder Dislocation?
The shoulder is a ball-and-socket joint, providing a wide range of motion, but this flexibility also makes it susceptible to dislocations when exposed to sudden or excessive force. These dislocations can be partial (subluxation), where the ball of the joint partially slips out of the socket, or complete, where the ball is entirely displaced. Both types can lead to discomfort and hinder shoulder function.
Recognising a Dislocated Shoulder
The symptoms of a dislocated shoulder are typically immediate and often severe. Common signs include:
Intense Pain
Sharp, intense pain occurs as soon as the shoulder is dislocated, making even small arm movements difficult. Pain may persist until the joint is repositioned.
Deformity
The affected shoulder often appears visibly different, such as a flattened contour or a noticeable bulge, compared to the other side.
Limited Mobility
Movements become significantly restricted due to the joint displacement and associated discomfort.
Swelling and Bruising
The area around the shoulder may swell or show bruising due to inflammation and minor bleeding under the skin.
Numbness or Weakness
Tingling, numbness, or a weakened grip may result from pressure on nearby nerves or blood vessels.
Common Causes of Shoulder Dislocation
Several activities or incidents can result in a dislocated shoulder. The most common include:
Sports Injuries
Activities such as rugby, football, basketball, or volleyball involve sudden impacts or awkward arm movements, increasing the risk of dislocation. Overhead motions, such as throwing, also put strain on the joint.
Accidents
Falls, particularly onto an outstretched arm, or high-impact incidents like car accidents can exert significant force, pushing the shoulder out of place.
Repetitive Motion
Repeated overhead movements, such as swimming or certain jobs requiring lifting, can weaken the ligaments and make the shoulder more susceptible to dislocation over time.
Types of Shoulder Dislocations
Dislocations are categorised based on the direction of the humeral head’s displacement.
Anterior Dislocation
This is the most frequent type, where the humeral head moves forward out of the socket. It often occurs due to falls, direct impacts, or forced external rotation, as seen in sports or accidents. Anterior dislocations may stretch or damage the front shoulder ligaments.
Posterior Dislocation
Less common, this type happens when the humeral head is pushed backward. Causes include seizures, electric shocks, or direct force to the front of the shoulder while it is internally rotated. Without timely treatment, posterior dislocations can lead to labrum or cartilage injuries.
Inferior Dislocation
Rare and severe, this occurs when the humeral head is displaced downward, often from trauma like falling from a height or receiving a direct blow while the arm is elevated. Inferior dislocations frequently involve complications such as nerve or blood vessel damage.
Treatment Options for a Dislocated Shoulder
Treatment options for a dislocated shoulder aim to restore the joint to its normal position, promote effective healing, and minimise the chances of future dislocations. These approaches include non-surgical methods, which prioritise realignment and rehabilitation, and surgical procedures for addressing severe or recurrent cases.
Non-Surgical Treatment
Closed Reduction
A healthcare provider carefully manipulates the shoulder to move the humeral head back into its socket. This procedure is usually done under sedation or pain relief for comfort. Once reduced, pain subsides, and arm movement improves.
Immobilisation
After realignment, a sling or brace stabilises the joint, allowing ligaments and tissues to heal. Immobilisation duration varies based on the injury’s severity and the patient’s activity level.
Physiotherapy
Rehabilitation begins with gentle exercises to restore range of motion. Gradual strengthening of the shoulder and surrounding muscles follows, improving joint stability and reducing future dislocation risk. A tailored physiotherapy plan ensures steady progress.
Surgical Treatment
Ligament or Capsule Repair
Surgery may be needed when ligaments are torn or the shoulder remains unstable after non-surgical treatment. Tightening or repairing these structures helps stabilise the joint.
Reconstruction Procedures
Severe or recurrent dislocations may require reconstructive surgery, such as grafting or reattaching ligaments, to restore the shoulder’s function and stability.
Arthroscopic Surgery
Minimally invasive surgery is often performed to repair soft tissue damage or correct structural issues. This approach typically involves shorter recovery times and less post-operative discomfort compared to open surgery.
Preventing Shoulder Dislocations
Preventing shoulder dislocations involves strategies to enhance joint stability and reduce strain. Strengthening exercises targeting the shoulder, rotator cuff, and upper back improve support and decrease the risk of dislocation.
Using proper techniques during overhead or repetitive activities, such as lifting or throwing, helps minimise unnecessary stress on the joint. Additionally, wearing protective gear like shoulder braces in high-risk sports or activities provides extra stability and reduces injury risk.
Conclusion
A dislocated shoulder can affect daily activities and long-term joint health if not managed properly. Recognising the symptoms and seeking timely treatment can aid recovery and help prevent future occurrences. Applying preventive strategies helps maintain a healthy and stable shoulder.
Contact Dr LS Wang today to explore personalised solutions for your shoulder concerns.