Dislocated Shoulder

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Shot of a young athlete with an injured rightshoulder at gym

A dislocated shoulder injury  occurs when the top of the upper arm bone (the humerus) fails to return to its normal position in the cup shaped shoulder blade socket. Specifically, a dislocation refers to a complete displacement while a subluxation refers to a partial one.

X Ray Image Of An Anterior Shoulder Dislocation
X Ray Image Of An Anterior Shoulder Dislocation

This type of injury can in some cases be the result of a pulling force exerted on the arm in an upward, outward or backward direction. In others, it is the result of falling onto an outstretched arm or receiving a direct powerful blow to the shoulder. Another possible cause of a dislocated shoulder is a seizure (e.g.an epileptic seizure or an electric shock).

Types Of Dislocated Shoulder

There are three types of dislocated shoulder injury depending on the direction of the dislocation. The most frequent is called an anterior dislocation and occurs when the upper arm bone is displaced toward the front of the body. 95% of shoulder dislocations are of this type, and in most cases they occur in contact sports due to falling onto an outstretched hand or collisions between athletes. Among older individuals, it is usually the result of falling.

In posterior dislocations , the arm bone displaced  towards the back of the body. These are much rarer than anterior dislocations and tend to be the result of brain seizures or electric shocks. In some very infrequent instances, this type of dislocation can occur from falling onto an outstretched arm or receiving a blow to the front of the shoulder.

Finally, and by far the rarest type of dislocated shoulder, is the inferior dislocation, represented by downward displacement of the arm bone. It is usually the result of someone or something exerting a powerful downward force on the arm.

Causes

This is almost always a traumatic (as opposed to a repetitive stress) injury that results from a single discrete event. Individuals with unusually loose shoulder ligaments (supposed to hold the arm bone in position) are especially prone to suffer dislocated shoulders.

Symptoms Of A Dislocated Shoulder

If you have suffered a shoulder dislocation, you are likely to experience the following symptoms:

  • Severe pain in your shoulder, as well as difficulty moving the joint. You may also be experiencing muscle spams with each spasm accompanied by more intense pain;
  • Your shoulder may appear to have an unusual shape, particularly when someone views it from the side;
  • There may be a hard bony protusion under the skin near the shoulder socket. This would be the “ball” of the upper arm bone that has popped out of the shoulder socket;
  • In some cases, you may notice bruising in your shoulder region.

Treatment Of A Dislocated Shoulder

After confirming that you have a dislocated shoulder, your doctor will probably first try to ease any muscle spasms you may be experiencing. He or she will do this by pain reducing medication to help your shoulder muscles to relax.

Once that is done, your doctor may then be able to follow a closed reduction process by easing the top of your upper arm bone back into the shoulder socket. As part of this process, doctors may use arm weights to help extend excessively tight muscles and make it easier to restore the arm bone to its original position.

Once your arm is back in your shoulder socket, your doctor may recommend that you wear an arm sling or shoulder brace for a few weeks to help the injury heal.

As you reach the later stages of your recovery, your doctor may refer you to a physiotherapist who can design a rehabilitate shoulder exercise program for you to follow. The aim of this program will be to prevent your extended period of shoulder inactivity from developing into a frozen shoulder problem. You will be given a series of shoulder exercises that you can probably complete at home using a shoulder pulley.

Surgical Treatment

In many cases, the first instance of a dislocated shoulder makes repeat occurrences more likely and can bring on shoulder instability. This can be especially likely if you are a young athlete who frequently participates in contact sports like hockey or football. In these situations, doctors may need to use surgery to correct the instability and reduce the risk of recurrence of your dislocated shoulder. For older individuals with dislocated shoulders, the risk of a repeat injury is much lower, and so is also the need for surgical intervention

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