Shoulder Dislocation: Causes and Treatment

A shoulder dislocation occurs when the head of the humerus (upper arm bone) is forced out of the glenoid socket. The shoulder is the most commonly dislocated joint in the body due to its wide range of motion and relatively shallow socket.

Causes of Shoulder Dislocation

1. Trauma or Impact:
   • Sports Injuries: Common in contact sports (e.g., football, rugby) or activities with high-speed arm movements (e.g., baseball).
   • Falls: Falling on an outstretched arm or directly onto the shoulder can dislocate the joint.
   • Motor Vehicle Accidents: High-impact forces can dislocate the shoulder.
2. Overhead Activities:
   • Repeated overhead motions can loosen ligaments, making dislocations more likely (e.g., in swimmers or pitchers).
3. Shoulder Instability:
   • Congenital or acquired laxity of the ligaments can predispose to dislocation.
4. Previous Dislocation:
   • A history of dislocation increases the likelihood of recurrence due to weakened ligaments and joint structures.
5. Weak Rotator Cuff or Scapular Muscles:
   • Poor muscle support around the joint increases instability.

Types of Shoulder Dislocations

1. Anterior Dislocation:
   • The humeral head moves forward and out of the socket.
   • Most common type (95% of cases).
2. Posterior Dislocation:
   • The humeral head moves backward, often due to seizures, electric shocks, or trauma.
3. Inferior Dislocation (Rare):
   • The humeral head moves downward, usually from a forceful hyperextension.

Symptoms of Shoulder Dislocation

• Severe Shoulder Pain:
  • Intense pain immediately after the injury.
• Deformity:
  • The shoulder may look visibly “out of place” or flattened.
• Limited Movement:
  • Difficulty or inability to move the arm.
• Swelling and Bruising:
  • Around the shoulder joint.
• Numbness or Tingling:
  • In the arm or hand, indicating possible nerve involvement.

Treatment for Shoulder Dislocation

Immediate First Aid

1. Immobilize the Shoulder:
   • Use a sling or brace to stabilize the arm and prevent further injury.
2. Ice Application:
   • Apply ice packs for 15–20 minutes to reduce swelling and pain.
3. Seek Medical Attention:
   • Avoid attempting to relocate the joint yourself as this can cause nerve or blood vessel damage.

Medical Treatment

1. Closed Reduction:
   • A trained healthcare provider manipulates the shoulder back into place.
   • Immediate pain relief often follows successful reduction.
2. Imaging:
   • X-rays or MRI to confirm the dislocation, assess damage, or rule out fractures.
3. Immobilization:
   • After reduction, a sling or brace may be used for 2–3 weeks to allow healing.
4. Pain Management:
   • NSAIDs (e.g., ibuprofen) to reduce pain and inflammation.

Rehabilitation and Physical Therapy

1. Early Mobility Exercises:
   • Gentle range-of-motion exercises to prevent stiffness.
2. Strengthening Exercises:
   • Focus on rotator cuff and scapular muscles to stabilize the shoulder.
3. Proprioceptive Training:
   • Improve joint awareness and coordination to reduce recurrence risk.
4. Gradual Return to Activity:
   • Avoid high-risk movements until strength and stability are restored.

Surgical Treatment

Surgery may be required for:

1. Recurrent Dislocations:
   • Repair or tighten ligaments and soft tissues (e.g., Bankart repair).
2. Associated Injuries:
   • Rotator cuff tears, fractures, or nerve damage.
3. Severe Instability:
   • Procedures like Latarjet surgery or bone grafting for significant bone loss.

Recovery Timeline

• Non-Surgical:
  • Full recovery typically takes 4–12 weeks with proper rehabilitation.
• Surgical:
  • Recovery can take 4–6 months, depending on the procedure and adherence to physical therapy.

Prevention of Shoulder Dislocation

1. Strengthen Shoulder Muscles:
   • Regularly exercise rotator cuff and scapular stabilizers.
2. Avoid Risky Activities:
   • Minimize high-impact sports or activities if you have shoulder instability.
3. Correct Technique:
   • Use proper form in sports or weightlifting to reduce stress on the shoulder.
4. Protective Bracing:
   • Use braces or supports during high-risk activities if you have a history of dislocations.
5. Warm-Up and Stretch:
   • Prepare muscles before physical activity to prevent injury.