Shoulder dislocation is one of the most common injuries affecting the upper body, and has the potential to cause both immediate pain at the time of injury and long-term joint instability. The shoulder joint, which is one of the most mobile joints in the body, allows for a wide range of movements such as lifting, rotating and twisting but is also vulnerable to dislocation due to its complex structure and the forces it is subjected to during daily and sports activities. Dislocation of the shoulder occurs when the head of the humerus is forced out of the glenoid of the scapula, disrupting the normal alignment of the shoulder joint.
A shoulder dislocation can be categorized into:
- Anterior dislocation (the most common type of shoulder dislocation) in which the head of the humerus moves forward, out of the joint.
- Posterior dislocation (less common) occurs when the head of the humerus moves backwards.
- Inferior dislocation (extremely rare), in which the humeral head moves downwards.
While shoulder dislocations can be acute events, they often lead to chronic joint instability, increasing the likelihood of recurrent dislocations if not treated properly.
What causes shoulder dislocation?
The main cause of shoulder dislocation is an injury, however several factors can increase the risk of injury. Common causes include:
- Falling on an outstretched arm or directly on the shoulder is a common cause of dislocation, especially in contact sports such as football.
- Direct hit for example from a car accident.
- Activities involving throwing, lifting or sudden rotational movements that put pressure on the shoulder and increase the risk of dislocation.
- Anatomical abnormalities such as loose ligaments.
- Previous dislocation, which increases the chances of recurrence.
- Age and activity level. Shoulder dislocation is more likely to occur in athletes and active people and in older people due to falls and degeneration of the ligaments and the muscles/tendons of the shoulder.
The symptoms of a shoulder dislocation
The symptoms of a shoulder dislocation are usually immediate and obvious. The most common are:
- Intense pain in the shoulder joint, often radiating down the arm. The pain usually worsens with movement or any attempt to use the arm.
- In an anterior shoulder dislocation, the shoulder may appear visibly deformed, with the head of the humerus displaced forward. This is often accompanied by swelling and bruising around the joint.
- Limited range of motion and a feeling that the joint is 'locked'.
- Numbness or tingling in the arm or hand if the shoulder dislocation compresses nearby nerves.
- Muscle spasms that further restrict movement and increase pain.
A medical history and physical examination are necessary to diagnose shoulder dislocation. Also, imaging tests are usually necessary to confirm the diagnosis and assess the extent of the injury, usually with X-rays and MRI or CT scans.
How the shoulder dislocation is treated
Treatment of shoulder dislocation usually involves two main stages: reducing the dislocation and treating any underlying damage to the structures of the joint. The treatment approach depends on whether the dislocation is acute or recurrent.
- The first step in the treatment of a shoulder dislocation is to reduce (or reposition) the humeral head back into the glenoid socket. This is usually done under sedation or local anesthesia to minimize pain and muscle spasms. Various techniques can be used, such as the Kocher or Stimson technique, which involve specific manoeuvres to safely reposition the bone.
- Once the dislocation is reduced, the shoulder is usually immobilized with a splint to allow the ligaments and tissues to heal. Ice therapy and painkillers can help manage the swelling and pain.
- Physiotherapy can also help with rehabilitation both by strengthening muscles and improving range of motion.
In cases of recurrent dislocation or where there is significant damage to the ligaments, surgery may be required, with various options available depending on the extent of the damage. Arthroscopic techniques are used typically offering smaller incisions and faster functional recovery.
Prevention tips for shoulder dislocation
Prevention of shoulder dislocations is possible by strengthening the muscles and ligaments surrounding the shoulder joint, proper technique (especially in sports involving overhead movements) to reduce shoulder strain, and the use of shoulder braces or taping in high-risk activities.
Shoulder dislocation is a serious injury that can cause severe pain, loss of function and long-term joint instability if not treated properly. Whether treated conservatively or surgically, effective management of shoulder dislocation is extremely important in order to restore mobility and prevent long-term complications.
To learn more about shoulder dislocation and the treatment options available, contact us at 6943903343 (secretariat) or 6949196061 (physician) and at orthopedikos-papagiannopoulos.gr and make an appointment.
