The shoulder is one of the most complex joints in the body. It has the greatest range of motion of all joints in the body allowing it to move and position the hand in any direction.
Although we may think of the shoulder as a single joint, it is really a complex structure of bones (the scapula, clavicle and humerus) as well as ligaments, tendons and muscles that coordinate together to allow the shoulder’s range of movement.
Because of the shoulder’s ability to have such free movement, it would seem logical that it should be unstable, but the sophisticated structure of ligaments, muscles and tendons serves to keep the joint in place. Because of the mobile nature of the shoulder however, it is more prone to dislocation than other joints – in fact the shoulder is the most frequently dislocated joint of the body. Anyone is susceptible to shoulder dislocation, but there is a higher rate of incidence in young physically active males.
What is a shoulder dislocation?
The shoulder is in essence a ball and socket joint and dislocation occurs when the top of the upper arm bone (humerus), which is the ball section of the joint, is forced out of the socket (glenoid).
As the shoulder moves in different directions, it can dislocate forward, backward or downward either as a complete or partial dislocation, however the most common dislocations are located at the front of the shoulder. Shoulder dislocations can be further complicated when the fibrous tissues surrounding the bones are stretched or torn.
What causes shoulder dislocation?
There are some common causes of shoulder dislocation including:
- Sports injuries. Involvement in contact sports and those sports that may include falls and overhead activity, including all football codes, hockey, boxing, volleyball, basketball and gymnastics.
- Trauma from a hard blow not related to sports such as a car accident or workplace injury.
Once you have had a shoulder dislocation the joint may become unstable and be susceptible to repeat dislocations.
What are the symptoms of a dislocated shoulder?
Symptoms will vary depending upon the severity of the injury, but symptoms that can indicate a shoulder dislocation include:
- Bruising or swelling
- Intense pain
- Inability to move the joint
- The shoulder looking out of place or deformed
You may also experience numbness or tingling surrounding the joint, in your neck or your arm and the joint may “spasm” increasing the intensity of the pain.
A more severe injury may have other complications including:
- Tears in the muscles, ligaments and tendons that provide stability and reinforce the shoulder
- Nerve or blood vessel damage
- Instability of the joint – particularly if the dislocation is severe or repeated
How can shoulder dislocation be prevented?
There are some basic steps to take to help prevent dislocation including:
- Regular exercise focused on maintaining strength and flexibility
- Avoiding falls
- Wearing protective gear when playing contact sports
If you have had a previous dislocation, undertake an exercise program to strengthen and stabilise the shoulder. An exercise regime can be designed for you by your doctor and/or physiotherapist.
What to do if you have a shoulder dislocation?
Shoulder dislocation is a serious and painful injury and you should seek immediate medical treatment.
After examining your shoulder and obtaining an x-ray, your shoulder will have to be put back into place.
Treatment options will vary depending upon the severity of your injury. In some instances, the doctor will be able place the ball of the joint back into the socket. This is called a “closed reduction” and you will find that your severe pain will cease as the shoulder joint is back in place.
You may then need to have the shoulder immobilised in a sling for a period of time to rest the joint and follow a regime of icing the joint to reduce pain and swelling. As the shoulder heals a rehabilitation program is put in place to help strengthen the muscles and restore range of motion.
If the injury is more serious or if you have suffered repeated dislocations, you may need surgery to tighten any loose ligaments and secure torn tendons and ligaments to stabilise or effectively ‘reconstruct’ the shoulder; this procedure is known as a shoulder stabilisation or shoulder receonstruction and in most cases our surgeons perform this procedure as key hole surgery (arthroscopically).
How do I arrange for a consultation?
If you have suffered a shoulder dislocation or continue to have repeated dislocation and would like to discuss what treatment options are available, please arrange for a consultation with our specialist shoulder surgeons by calling our office on 1300 399 223.