Shoulder Dislocations & How We Treat Them

Dislocations of the shoulder joint can be painful to deal with and can happen for a number of reasons. More often than not, shoulder dislocations occur when force if placed on the outstretched arm. This could happen in contact sports such as football where a player might receive a sharp force to his shoulder as he goes for a mark or is tackled. Another example would be an older person who is trying to break a fall with their arm.

Shoulder dislocations themselves can be a complete dislocation where the joint surfaces of the shoulder are no longer in contact or a subluxation where the shoulder joint is partially intact. Some people might also be predisposed to frequent shoulder dislocations due to the integrity of their shoulder joint. A good example of this is people with shallow glenoid surfaces that do not fully encapsulate and enclose the ball of the humeral head.

As a lot of important arteries and nerves travel through the shoulder joint, assessment of damage to these vessels is critical during dislocation, as well as investigating for any potential fracture to the shoulder joint itself. For a formal diagnosis, a scan such as an x-ray or MRI would be essential to determine the level of damage involved.

Once a formal diagnosis has been performed, the type of treatment can vary depending on the severity of the dislocation or subluxation present:

• Closed Reduction: this involves manually maneuvering the shoulder bones back in place. As this can be quite painful, a muscle relaxant or pain medication would be beneficial. However, once the bones are positioned back in alignment, any immediate pain associated with the initial dislocation should resolve.
• Surgery: this would be an option for people with reoccurring dislocations. For example, as mentioned above, people with shallow glenoid sockets. If there is damage to either the blood vessels or nerves around the shoulder, this might also warrant surgery.
• Immobilization: wearing a sling might be recommended by your physical therapist after closed reduction to ensure the joint stays intact after maneuvering it back together.
• Rehabilitation: after wearing a sling or having surgery, it would be beneficial to have some physiotherapy to restore your shoulder range, improve the strength in your shoulder, particularly the shoulder stability muscles such as your rotator cuff. This is critical in preventing further dislocations down the track.

If you need help with your shoulder dislocation, reach out to us today!