Shoulder Dislocation Common in Young Athletes

By Shelagh McNally for Shoulder1

The good news is that more and more high school students are participating in sports. According to the National Federation of State High School Associations, the number of high school athletes has risen steadily since 2000. The bad news is the increase in sports-related injuries.

Take Action

Self-care after reduction: Follow the R.I.C.E. treatment plan: Rest the injured joint as much as possible during the first 24 to 48 hours after the dislocation. Ice the injured area at 20 to 30 minutes. Repeat every hour until the swelling is reduced. Compress the area with a sling or bandage. Numbness, tingling or pain means the bandage is too tight. Elevate the shoulder above heart level to help circulation. Take acetaminophen, ibuprofen or naproxen sodium for pain according to the recommended dosage on the label and follow up with your doctor to start a rehabilitation program to repair the injured socket.

The dislocated shoulder is quickly becoming the most common athlete injury, the result of a collision or a fall onto an outstretched arm as seen in football, basketball, soccer, judo or wrestling. Male athletes, particularly those under the age of 25, are more prone to this type of injury simply because they play more contact sports than female athletes do.

A dislocated shoulder is excruciatingly painful and incapacitating. The main symptom is severe pain at the shoulder joint and difficulty moving the arm. The shoulder often feels soft and mushy to the touch, and it may look asymmetrical. Usually the person knows when their shoulder is dislocated but sometimes the only way to confirm the injury is through an X-ray.

The shoulder joint is one of the most mobile but one of the most unstable joints in the human body. The joint is made up of three bones coming together in one place: the arm bone (humerus), the shoulder blade (scapula), and the collarbone (clavicle) all meet at the top of the shoulder. The ball and socket of the shoulder, known as the glenohumeral (G-H) joint, rests between the humerus and scapula. For added stability and to make the socket deeper there are extensions of the ligaments known as the glenoid labrum. This set-up allows us to throw, catch, receive and serve – all useful movements when playing sports – but it also makes the joint weak.

A shoulder dislocation occurs when the humerus loses contact with the scapula. Due to the physiology of the joint, 95 percent of dislocations are anterior, where the humerus pops out and rests in front of the shoulder blade. A posterior dislocation, when the humerus is behind the shoulder blade, is usually seen after an electrocution or seizure. Almost all sports injuries are anterior dislocations caused when the athlete’s shoulder is wrenched upward or backwards – the kind of action that happens during a fall or collision with another person. The classic football tackle is a perfect example.

Take Action

Rehabilitation exercises for disclocated shoulders: Shoulder shrugs Bicep curls Chest raises Saws Pendulum swings Shoulder rotation Shoulder Flexion Towel stretch Flexed elbow pull

Emergency care should be sought immediately after a dislocation. Waiting can cause further damage to tendons, muscles, nerves and blood vessels. The cure is quite simple but painful: The doctor performs a reduction. In a reduction, the doctor uses the weight of the body and gravitation to guide the humerus back into the socket. Usually a painkiller or muscle relaxant is given to help the patient relax. After the reduction, the arm should be immobilized for two to six weeks, followed by a full rehabilitation and strengthening program to reduce the risk of re-injury.

While the shoulder will heal, studies show that dislocation reoccurs in 80 percent of most cases. Doctors and sports therapists recommend waiting to return to practice and competition until all symptoms are gone and the strength of the affected arm is back to normal.

Last updated: 09-Sep-05