Recurrent Dislocation of Shoulder

Dislocated Shoulder

Dislocations happen when something pushes the bones in your shoulder joint out of their usual place. Falls, sports injuries and car accidents are the most common causes. Never try to force your shoulder back into place. Keep your arm still and close to your side and go to the emergency room right away if you think your shoulder is dislocated.

What is a shoulder dislocation?

A joint is any place in body where two bones meet. Shoulder joint is where the round ball at the top of your upper arm bone (Humerus) fits into the socket (glenoid) of your shoulder blade (scapula). Shoulder dislocation occurs when head of humerus(ball) displaces out of glenoid socket and the ball and socket connection of shoulder joint is disrupted. This can damage muscle, ligament, nerve and blood vessels around the joint.

Types of dislocated shoulders

How common are dislocated shoulders?

Shoulders are the most commonly dislocated joint.

Symptoms & Causes

The most common symptoms of a dislocated shoulder include:

Extreme pain.
Inability to move your shoulder or arm.
Shoulder appears empty and visibly out of place.
Swelling.
Bruising or discoloration around shoulder joint
Numbness, tingling or weakness in your arm, hand or fingers.

Causes of shoulder dislocation

Force strong enough to push your shoulder joint out of place can cause a dislocation. The most common causes include:

People at risk for shoulder dislocation

Complications of a Shoulder dislocation

The most common complications of shoulder dislocation are damage to the bones and tissues around your shoulder, including:

People who dislocate a shoulder develop a Bankart lesion and/ or Hill-sach’s lesion. A bankart lesion is tear in capsule and labrum tissue which hold the shoulder joint in place. A Hill-Sachs lesion is like a dent in the ball of your upper humerus. After dislocation head of humerus is pressed against the glenoid neck and rim of scapula, which damages or dent the head of humerus (ball).

Diagnosis & Tests

How are dislocated shoulders diagnosed?

Orthopaedic surgeon can easily diagnose a dislocated shoulder with a physical exam and few examination test in emergency room or clinic.

Investigations needed to diagnose and plan further management of shoulder dislocation.

Management & Treatment

How are dislocated shoulders treated?

Go to the emergency room right away if you think your shoulder might be dislocated.

The most important treatment for a dislocated shoulder is getting your arm back into its socket. This is called a closed reduction or manipulation. During this nonsurgical procedure, The Orthopaedic surgeon will physically manoeuvre to set (align) your shoulder under sedatives to relax the body.

Don’t try to reduce shoulder joint in place by yourself. Don’t let anyone who’s not a trained professional healthcare provider move your injured shoulder. Immobilise shoulder joint as still. If you try to force a dislocated shoulder back in place on your own, you can make your injury worse and damage the tissue around it.

After your provider puts your joint back in place, you might need other treatments, including:

Immobilization: After closed reduction, patient has to wear shoulder immobiliser for 4 weeks. This will heal soft tissues around shoulder joint, if not done can hampers the healing of these tissue and shoulder can again dislocates.
Medication: Analgesics to reduce pain and inflammation.
Rest: Avoid any physical activity that requires shoulder joint moments.
Physical therapy: After few weeks of rest, physical therapy is started to regain its strength and ability to move shoulder joint. Initially only gentle motion exercises to reduce stiffness are begun. Later the doctor or physiotherapist add in exercises to strengthen your shoulder muscles. This will help reduce your risk of future dislocations.

Dislocated Shoulder Surgery

Most people don’t need surgery after dislocating their shoulders. You may need surgery if:

The injury that dislocated your shoulder caused other damage inside your body.
A closed reduction doesn’t work or isn’t possible. In this case, you’ll need surgery to reset your shoulder joint.
You’ve dislocated the same shoulder in the past. You might need surgery to repair or tighten the ligaments that keep your arm attached to your shoulder blade.

Outlook / Prognosis

What is the outlook for a dislocated shoulder?

Most people make a full recovery after dislocating their shoulder. Even if you need surgery, you should be able to return to most or all your activities and sports after your shoulder has healed.

You’re much more likely to re-injure a shoulder you’ve dislocated before. Some studies have found that more than 90% of athletes younger than 25 who dislocate a shoulder during a contact sport re-injure the same shoulder in the future.

Prevention

Can I prevent a dislocated shoulder?

You can’t always prevent a dislocated shoulder. It usually happens because of unexpected accidents and trauma.

During sports or other physical activities:

Wear the right protective equipment.
Don’t “play through the pain” if your shoulder hurts during or after physical activity.
Give your body time to rest and recover after intense activity.
Stretch and warm up before playing sports or working out.
Cool down and stretch after physical activity.

Living With

When should I go to the emergency room?

Go to the emergency room if you’ve experienced trauma.

If you think your shoulder is dislocated:

Go to an emergency room or call 911 or your local emergency number.
Don’t move your arm. Keep it close to your body.
Don’t try to jam your shoulder back into place and don’t let anyone other than a healthcare provider try to. If anyone other than an expert tries to put your shoulder back into place they can damage blood vessels, muscles, ligaments and nerves.
Apply an ice pack to the injured area to reduce swelling and pain.
Over-the-counter NSAIDs can help reduce your pain and other symptoms. Don’t take more than the recommended dose.

Final Note

A dislocated shoulder happens when something forces the ball-shaped head of your upper arm bone out of the socket in your shoulder blade. Falls, sports accidents and other trauma usually cause dislocated shoulders. Shoulders are the most commonly dislocated joint.

Never try to reduce your shoulder back in place on your own. Don’t let anyone other than a healthcare provider touch or move it. Go to the emergency room right away if you think your shoulder is dislocated or you can’t move or use your arm.

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