A shoulder dislocation can be
a serious sports injury, often requiring surgical intervention and
weeks to months of rehab.
commonly seen with contact sports, dislocations are most common in
football, but can also occur in other sports.
dislocations occur, first step treatments, and surgical options can get
you back in the game quickly and safely.
is a Shoulder Dislocation?
Simply put, a it is when the head
of the humerus
comes out of the shoulder "socket" due to trauma of some kind.
majority of dislocations occur anteriorly: this means the humerus
slides out of socket toward the front of the shoulder. For a closer
look at what a dislocation is, lets explore the shoulder anatomy.
The shoulder, or glenohumeral joint, is comprised
of the humerus and the glenoid fossa of the scapula. While many call
the shoulder a ball and socket joint, it is not nearly as stable as the
hip, which is closer to a ball and socket.
best analogy for the
shoulder joint would be to imagine placing a basketball on a tea
saucer. The shoulder joint sacrifices stability for mobility.
primary stabilizing structures of the shoulder
are the joint capsule and the rotator cuff muscles. They work together
to keep the humerus centered on the glenoid.
overpowering stresses, the humerus can be dislodged from the glenoid,
resulting in a dislocation.
Another common injury similiar to a shoulder
dislocation is a shoulder subluxation. In essence, this is a partial
dislocation, where the humerus slides part of the way out of socket.
Shoulder subluxations often reduce spontaneously, meaning the humerus
returns to the socket on its own.
Learn More About Shoulder Anatomy
Mechanism of Injury
One of the most common ways to dislocate the shoulder is an external
rotation force while the shoulder is abducted.
with the arm in a position away from the body, often overhead, and then
with the arm rotated backwards.
This injury can
from falling on an outstretched arm, however this is not as common.
The most obvious symptom of a shoulder dislocation is the humerus being
out of socket. There is generally an obvious deformity, and the
shoulder looks "funny".
Since most dislocations
occur anteriorly, there
may be a large bump in the front of the shoulder where the humerus is.
Pain is usually significant with a dislocation, and you will generally
not be able to move the arm. Numbness or tingling of the arm and
fingers may accompany a dislocation as well.
When a dislocation occurs, many different tissues are injured. With
anterior dislocations, the anterior or front portion of the shoulder
capsule is stretched and torn.
In addition, the
labrum, or cartilage of
the shoulder, is also injured, often pulling away from the bone.
Commonly called a Bankart lesion
, this type of
labral tear is found in
98% of all anterior shoulder dislocations.
the pain with
shoulder dislocations is found in the front of the shoulder, and is due
to the damage to the soft tisses in this area.
You may also suffer from a depression fracture on the posterior or back
side of the humerus. This is called a Hill-Sachs lesion, and usually
will not need to be treated specifically.
Acute treatment for shoulder dislocations involves reduction of the
dislocation, or putting the humerus back into place. This should be
done only by a trained physician in an emergency room or hospital
Reduction may be performed with or
depending on how much the muscles have spasmed. The longer the shoulder
is out of socket, the harder it becomes to reduce the dislocation.
X-rays are generally taken before and after reduction to monitor the
position of the humerus.
Following reduction, a sling is applied, and should be worn
continuously for the next 2-3 weeks at a minimum. Immobilization of the
shoulder through a sling allows for the anterior capsule to heal, and
to prevent excessive stretching of the tissues. After 2-3 weeks of
sling use, shoulder rehabilitaiton
focusing on gently regaining range
of motion, and then progressing to strengthening excercises.
Return to play following this injury can generally occur 3-4 months
after injury, depending on the type of sport. Regaining full range of
motion and strength is vitally important, as well as improving the
overall stability of the joint.
After a dislocation, the chances of a subsequent dislocation
are greatly increased. Over half of all athletes who suffer from this
injury will have another dislocation if not treated surgically.
due to the stretching of the shoulder capsule, and the likeliness of
the Bankart lesion. With this in mind, acute dislocations are
sometimes treated surgically within the first 1-2 weeks. Whether or not
to have surgery can be a complicated decision, and this should be
discussed with your orthopedic surgeon.
dislocations are a serious sports injury and must be treated
appropriately in order to recover fully. Rest, immobilization, and
rehabilitation are essential for the best outome. Even with proper
treatment, some shoulder dislocations result in instability and may
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