Shoulder Dislocation (Dislocated Shoulder)

The shoulder joint is one of the largest joint in the body and is the most mobile among the joints. However, because of its anatomical structure, it is also one of the most common joint dislocated.

A shoulder dislocation happens when the bones comprising the joint becomes separated in such a way that the joint no longer functions normally as they should.

The Shoulder Joint

Your shoulder joint, also called glenohumeral joint, is comprised of two bones: the upper ball portion of your upper arm (humerus) and the shallow socket portion of your shoulder blade (scapula). The joint is held in place by muscles (e.g. rotator cuff), ligaments, and other tissues.

Direction of Shoulder Dislocation

Because the ball or head of the humerus sits on a shallow socket, it can be easily displaced when enough force is exerted. Two common ways in which dislocation of the shoulder can occur are anterior and posterior dislocation. When the ball part of the humerus is displaced forward, away from the socket, it is called anterior shoulder dislocation. When displacement is towards the back, it is called a posterior shoulder dislocation. Downward or inferior dislocation of the shoulder joint is less common.

Causes

Shoulder dislocation commonly affects people who engage in contact sports, such as football, wrestling, and rugby. Other sports activities that cause this shoulder injury include soccer, downhill skiing, and volleyball. Sometimes, the condition may be caused by a violent twisting of the upper arm, such as that occurs during seizure or as a result of electric shock.

In some, falling on an outstretched hand or a direct blow to the shoulder during vehicular accidents may also cause dislocation.

Symptoms

The most common symptom of shoulder dislocation is pain. Other signs and symptoms may include
  • arm appears to be out of position
  • swelling
  • numbness
  • weakness or inability to move the joint
  • bruising

Treatment

Shoulder dislocation is a medical emergency and should be looked at by a healthcare professional. While on your way to the emergency room, you can apply ice over the joint to reduce pain and swelling.

Your doctor will be repositioning the ball of the humerus back into your joint socket. This procedure is called closed reduction. Your symptoms of severe pain may stop immediately once the joint is aligned or put back in place.

Your arm will be stabilized with the use of a sling or shoulder immobilizer for several weeks to allow healing. Your doctor may advise you to apply ice three to four times a day, 20 minutes at a time. After swelling and pain has subsided, your doctor may recommend you to undergo physical therapy to restore normal shoulder joint function.

In severe cases where other shoulder structures are involved, surgery may be necessary.

Physical Therapy treatment Options for Shoulder Dislocation:

  • Ice / Hot pack application as determined by the physical therapist
  • Range of Motion (ROM) Exercises/Active Assistive Range of Motion Exercises (AAROME)/ Active Range of Motion Exercise (AROME)
  • General conditioning exercises
  • Stretching Exercises
  • Strengthening/Stabilization Exercises
  • Patient education
    • About shoulder dislocation
    • Self-care of symptoms
    • Activity and work modification
    • Home exercise program
    • Injury prevention

**Avoid overhead movements during the initial phase of rehabilitation. Allow sufficient healing time before performing any exercise that involves overhead motions.

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References:
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Shoulder Problems . Accessed on October 21, 2010.

University Sports Medicine. What is a Dislocated Shoulder . Accessed on October 21, 2010.

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