Dislocated Shoulder
Quick Reference
Reviewed by Dr. Peter Simonian
The shoulder is the junction of three bones: the humerus (upper arm bone), the clavicle (collarbone), and scapula (shoulder blade). A group of four muscles and their respective tendons, known as the rotator cuff, connects the humerus to the shoulder socket, or glenoid, stabilizes the joint, and allows the upper arm to be lifted and rotated. In a dislocation, the humerus is forced out of the glenoid cavity by a strong blow or severe weakness of the rotator cuff. A dislocation can occur in one of three types: anterior (forward), posterior (backward), and inferior (downward). An anterior dislocation of the shoulder is by far the most common dislocation. Because of the great range of motion allowed by the shoulder joint, it is the most-frequently dislocated joint in the body. A partial dislocation of the shoulder is known as a Subluxation. A full dislocation is very painful, and, since the rotator cuff tendons are weakened when it occurs, the chance of recurrent dislocation, a condition known as instability, increases with each occurrence.
Detailed Description
Symptoms
Extreme pain, noticeable abnormality of shoulder when compared to other, possible loss of feeling if axilla (armpit) nerves are damaged. Swelling, bruising and tenderness will always follow the injury.Causes and Risk Factors
Causes
Since shoulder dislocations most often occur in the anterior (frontward) direction, the most common way to dislocate it is to suffer a backwards blow while the shoulder is raised. The condition can also be caused by a stiff upward or backward blow to the shoulder.
Risk Factors
Wrestlers, basketball players and football players comprise the biggest risk group for shoulder dislocations. Twisting, lifting and hitting, as well as throwing sports, also pose a higher risk of dislocation. Those with arthritis, degeneration of the rotator cuff, or poor muscle tone are also at great risk.
Treatment
Immediate Action:
If a dislocation is suspected, gently place the arm in the most comfortable position across the chest. If this is not possible, use medical tape or bandages to secure the arm gently to the side of the body. Do not try to force the bones back into place, as this will often worsen the condition. Seek a doctor or emergency room immediately.Procedures
A doctor will perform a reduction, or relocation of the shoulder, to place the head of the humerus back into the glenoid socket. Following the procedure, the doctor will most likely order the patient to wear a sling for three to four weeks. For recurrent dislocations or subluxations, open shoulder stabilization, Arthroscopic Stabilization, or thermal stabilization may be ordered.Medications
Non-steroidal anti-inflammatory drugs (as directed), local and general anesthetic for reduction.Prevention
Strong rotator cuff muscles remain the strongest defense against shoulder dislocation. Exercises that build up these muscles around the shoulder should be done. Adequate warm-up before activity and avoidance of high-contact sports will help prevent a dislocation.
Last updated: 10-Oct-00
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