Dealing with a dislocated shoulder
The shoulder is the most mobile joint in our body and you can move your shoulder in many different directions (ball and socket joint). With the given mobility, it does come with disadvantages in which the shoulder joint is prone to dislocation.
In normal circumstances, your humeral head would sit in the glenoid socket. When it is dislocated, this means that the humeral socket is dislodged from its glenoid socket and would cause the person to experience excruciating pain and inability to move the arm.
Types of shoulder dislocation
A partial dislocation of the shoulder joint is referred to as a shoulder subluxation. This happens when the upper arm bone's ball, known as the humerus, partially pops out of the glenoid socket in the shoulder.
A complete dislocation is divided into anterior, posterior and inferior. When the humeral head dislodges to the front, it is known as anterior dislocation. If it dislodges to the back, it is known as posterior dislocation and if the head dislodges downwards, it is known as inferior dislocation. Anterior dislocation is the most common shoulder dislocation whereas posterior and inferior dislocation accounts for less than 5% of all shoulder dislocation.
The cause
The shoulder is the most commonly dislocated joint in the body. Shoulder dislocations happen when there is too much stress is put on the shoulder joint or extreme rotation of your shoulder joint can cause the ball of your upper arm bone to pop out of its socket. This may be due to a forceful impact while playing sports or during a fall or even in a car accident. When the shoulder is dislocated, the joint is weakened and is very likely to dislocate again when the arm is in a throwing position.
What are the symptoms of a dislocated shoulder?
Symptoms of a dislocated shoulder include:
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A visibility deformed shoulder joint/bulge
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Swelling or bruising
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Intense pain
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Inability to move the joint
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Numbness or tingling near the injury, such as in your neck or down your arm
If you come across signs and symptoms of a dislocated shoulder, get immediate medical attention. Try not to move the shoulder joint or force it back into its place as it can injure the surrounding muscles, ligaments, blood vessels and nerves.
Treatments
Dislocated shoulder treatment may involve:
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Closed reduction. If the shoulder does not relocate on its own, the doctor may try some gentle manoeuvres to help your shoulder bones back into their proper positions. Depending on the amount of pain and swelling, the doctor may provide muscle relaxants or sedatives before moving the shoulder back into its place. When both bones are back in place, the severe pain should improve almost immediately.
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Immobilization. The shoulder may be sore and maybe weak and prone to dislocation again within the first few days. The doctor may use a special splint or sling from a few days to three weeks to keep the shoulder in place from moving as it is recovering. The duration of the splint or sling to be worn depends on the severity of the condition.
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Rehabilitation. After the shoulder splint or sling is removed, a rehabilitation program may be introduced to restore range of motion, strength and stability to their shoulder joint.
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Medication. The doctor may prescribe a pain reliever or a muscle relaxant to keep you comfortable while your shoulder heals.
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Surgery. If the shoulder joint is weak or recurrent shoulder dislocations tend to occur despite proper strengthening and rehabilitation, surgery may be an option. In rare cases, surgery is done to fix nerves or blood vessels that are damaged.
But besides these, what are the things that can be done at home?
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Well, there are a couple of things that could be done at home. To help ease discomfort and encourage healing after being treated for a dislocated shoulder:
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Rest the shoulder. Do not repeat specific actions that caused the shoulder to dislocate and try to avoid painful movements. Heavy lifting or overhead activity is heavily discouraged until the shoulder feels better.
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Apply ice then heat. Putting ice on the shoulder helps reduce the swelling. Do this 15 to 20 minutes at a time and do this every couple of hours for the first two days. After two days and when the swelling and pain have reduced, apply hot packs to help relax tight and sore muscles. Apply them not more than 20 minutes at a time.
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Maintain the range of motion of the shoulder. After one or two days or after the sling or splint is removed, do some gentle exercises as directed by the doctor or physical therapist to help strengthen the shoulder muscles. Inactivity of the shoulder could cause stiff joints.
Prevention
One thing to note is that once a person has dislocated their shoulder, they would be prone to future shoulder dislocations. Therefore, the best preventive steps to be taken are to avoid falls, wear protective gear such as a shoulder brace when playing contact sports and make sure to exercise the shoulder regularly to maintain strength and flexibility in the joints and muscles.
Medically reviewed by Ashwini Nair, MB BCh BAO.
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References
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Mayo Clinic. Dislocated shoulder [Internet]. 2020 [cited 2021Dec 10]. Available from: https://www.mayoclinic.org/diseases-conditions/dislocated-shoulder/diagnosis-treatment/drc-20371720
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eOrthopod. Shoulder Archives [Internet]. [cite 2021Dec 10]. Available from: https://eorthopod.com/category/shoulder/
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Eichinger JK. Shoulder Instability [Internet]. [cite 2021 Dec 10]. Available from: https://www.josefeichingermd.com/pdf/shoulder-instability.pdf
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OrthoInfo. Dislocated Shoulder [Internet]. [cite 2021 Dec 10]. Available from: https://orthoinfo.aaos.org/en/diseases--conditions/dislocated-shoulder/
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Cleveland Clinic. Dislocated Shoulder [Internet]. [cite 2021 Dec 10]. Available from: https://my.clevelandclinic.org/health/diseases/17746-dislocated-shoulder
