A dislocated shoulder is a very painful injury that occurs when your upper arm bone pops out of the socket in your shoulder joint. Because the shoulder is the most mobile joint in the body it is particularly susceptible to dislocation and there is a risk of repeated dislocations if the joint becomes unstable.
Causes of shoulder dislocation
The shoulder has a wide range of movement and can dislocate in different directions – forwards, backwards or downwards – according to how you were moving it when the dislocation occurred.
A partially dislocated shoulder (subluxation) means your upper arm bone is partially in and partially out of the socket, while a complete dislocation occurs when your upper arm bone is fully out of the socket.
First-time shoulder dislocations are normally caused by some kind of trauma such as a fall from a height or tripping and landing heavily onto the shoulder. A hard blow to the shoulder – for example, during a road traffic accident – can also cause the shoulder to dislocate and so can contact sports like hockey and rugby. The force of injury to cause a dislocation in people who have naturally very flexible joints the amount of trauma can often be much less.
Symptoms of shoulder dislocation
If the shoulder becomes dislocated you are likely to experience intense pain. You may be unable to move your shoulder and it may appear visibly deformed. There is likely to be swelling or bruising and you may experience spasming from the muscles in your shoulder. Your arm and neck may feel weak or might tingle.
What to do if you dislocate your shoulder?
It is essential to seek urgent medical help and not to try and force the bone back into place which can cause further damage. Applying ice to the shoulder can help reduce swelling and pain. Try using a sling or splint to hold the joint in one place and do not attempt to move it.
Is surgery necessary?
In the vast majority of cases, the medical professional will suggest an urgent closed reduction, which involves manipulating your shoulder bones to get them back into their proper position. It’s usually a good idea to get an x-ray done before and after this to make sure there are no fractures as well. You will normally need to wear a sling to keep the shoulder immobilised for a short period while you recover.
However, surgery may be needed if there is damage to the nerves or blood vessels around your shoulder joint or if the ligaments or tendons become stretched or torn. The aim of surgery will be to reduce the dislocation and minimise additional trauma. A weak or damaged shoulder joint or ligaments can be prone to further dislocation so corrective surgery may also help prevent recurrent dislocations. Any surgery will be followed by rehabilitation to restore strength, stability and movement to the shoulder.
Who might need surgery?
Males below the age of 25 are at highest risk of shoulder dislocation as they are at their peak of physical activity, and tend to suffer the most significant injuries. Almost half of all traumatic dislocations of the glenohumeral joint occur in patients between the ages of 15 and 29 and patients of this age have the greatest chance of recurrence and so may require surgery to repair soft tissue or bone damage. This is usually in the form of damage to the cartilage rim around the socket called the labrum.
Statistics show that males below the age of 20 have around a 72% chance of recurrent instability following a shoulder dislocation.
Surgery may also be needed if you are aged below 40 and suffer a badly torn labrum. In people over the age of 40, a torn rotator cuff is the leading reason for surgery after a dislocated shoulder. The chance of a torn rotator cuff rises with age – around 41% in people aged 40 to 55, and near 100% in people over the age of 70. Older patients who suffer extensive damage to the glenoid or humerus bone may also require surgery. Women over the age of 80 are at high risk of shoulder dislocation as a result of a fall.
Starting to use your shoulder joint too soon after a dislocation can also increase the risk of further dislocation, but leaving it too long will lead to stiffness, so it’s important to rest for the recommended time and to resume using your joint gradually with the help of a physiotherapist.
Orthopaedic Consultant & Surgeon | London
If you sustain an injury such as a shoulder dislocation, it is important to seek professional help. An orthopaedic surgeon can provide an accurate diagnosis and recommend the most effective type of treatment, which may include surgery.
Contact us to speak to a shoulder and elbow specialist who can outline your options.
Telephone: 020 376 15987