Symptom, Causes and Diagnosis of Dislocated Shoulder
Content
- What is a Dislocated Shoulder?
- Types of Dislocated Shoulders
- What Causes a Dislocated Shoulder?
- Who is Most Likely to Get a Dislocated Shoulder?
- What are the Signs of a Dislocated Shoulder?
- How to Diagnose a Dislocated Shoulder?
- How to Treat a Dislocated Shoulder
- How to Prevent a Dislocated Shoulder
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Key Takeaways
- Men involved in strenuous activities such as manual labour and contact sports are at risk of a dislocated shoulder.
- There are three types of shoulder dislocations: anterior, posterior, and inferior.
- Any force strong enough to push the shoulder out of its usual placement can cause dislocated shoulders.
- A dislocated shoulder may cause swelling, pain, decreased range of motion, and the shoulder deformity.
- A dislocated shoulder is usually treatable with conservative rehabilitative care, but severe cases may require arthroscopic surgery.
What is a Dislocated Shoulder?
A dislocated shoulder, medically known as glenohumeral joint dislocation, happens when the shoulder bone pops out of its socket and becomes misaligned. Being the most mobile joint in the body, the shoulder is at risk of dislocations, representing 50% of all major joint dislocations.
When you experience a dislocated shoulder, the ball at your upper arm bone, known as the humerus head, separates from your shoulder socket or the glenoid. Depending on the severity of the injury, you may experience complete or partial shoulder dislocation.
- Complete Dislocation (Luxation): This occurs when the humeral head of your shoulder is completely separated from the shoulder socket.
- Partial Dislocation (Subluxation): This happens when the humeral head of your shoulder is partially displaced from its normal location within the socket. Partial shoulder dislocations are temporary, but the soft tissues holding the humeral head in place are at risk of straining and tearing.
A dislocated shoulder is a common injury, mainly affecting men involved in sports and those performing manual labour. Once symptoms start to show, treating dislocated shoulders requires prompt medical attention and care.
Types of Dislocated Shoulders
Anterior Dislocation
This type of dislocation is the most common shoulder injury, accounting for 95% of cases. It mainly affects men between the ages of 18 and 25. Anterior dislocation occurs when the humeral head slides forward from the socket. It is usually caused by a heavy blow on the arm, either from an injury or an accident, damaging the ligaments and tendons in the shoulder (the rotator cuff ). In severe cases, the affected shoulder bone can be seen jutting forward.
Posterior Dislocation
Posterior shoulder dislocation is one of the less common shoulder dislocations, accounting for 2% to 4% of shoulder injuries. In contrast to anterior dislocations, posterior shoulder dislocations occur when the humeral head moves backwards from the shoulder socket. It typically occurs from muscle contractions during seizures or electric shocks, athletic trauma, and physical injuries at the neck or rotator cuff.
Inferior Dislocation
Inferior shoulder dislocation, scientifically known as luxatio erecta, is the least common type of shoulder injury, accounting for less than 1% of cases. Inferior shoulder dislocations happen when the humeral head moves downwards from the shoulder socket, moving the shoulders outside their normal range. Injuries on the nerves and rotator cuffs, for example, are common occurrences in inferior shoulder dislocation.
What Causes a Dislocated Shoulder?
Dislocated shoulders can occur when a force or activity pushes the shoulder joint out of its normal placement. Common causes of dislocated shoulders include:
- Falls: Falling and landing on your outstretched arm can dislocate a shoulder, especially if you had a nasty fall from a height.
- Sports injuries: Contact sports such as basketball and football and sports involving falls like skiing and gymnastics may cause a shoulder dislocation.
- Vehicle accidents: A hard impact on the shoulder from a car accident can dislocate your shoulder.
Who is Most Likely to Get a Dislocated Shoulder?
Dislocated shoulders can happen to anyone, but they commonly affect:
- Men, both who are involved in sports injuries and non-sports injuries.
- People between the ages of 15 and 30 years old.
- Athletes involved in contact sports and sports that involve falls.
- Anyone who has had a history of shoulder injury.
What are the Signs of a Dislocated Shoulder?
A shoulder dislocation may be physically evident with a lump or a bulge at the affected shoulder caused by swelling. The shoulder bone may also visibly jut out, changing the shape of the shoulder. Other symptoms of a dislocated shoulder include:
- A “pop” sound and sensation in the shoulder.
- Severe and sudden pain in the affected area.
- Muscle spasms and weakness.
- Decreased range of motion and mobility of the shoulder.
- Bruising and discolouration of the affected area.
- Numbness and pain in the fingers, hands, arms, and neck.
- Torn ligaments and tendons.
- Damaged nerves.
How to Diagnose a Dislocated Shoulder?
If you experience any symptoms of a dislocated shoulder, you should seek immediate medical attention. You will need to undergo a physical examination and a series of imaging tests for the doctor to diagnose a shoulder dislocation and determine their next course of action.
Physical tests
The doctor will check your affected shoulder and the rest of your arm for any deformities, swelling, tenderness, and other symptoms, such as discolouration of your skin and numbness of your arm and shoulder. Inform your doctor about any symptoms you experience and activities that may have caused your shoulder injury.
X-ray scans
Your doctor may request an X-ray scan to assess the severity of your dislocated shoulder. X-ray scans can help to determine if there is any bone damage and show the location and severity of the dislocation.
Computed Tomography (CT) scans
If the X-ray scan cannot identify the bone details clearly or the dislocation is complicated, your doctor may order a CT scan. The CT scan can provide a clearer image of the surrounding bone and soft tissues, making it easier to pick up minute details, such as hairline cracks or other damage to nearby parts of your shoulder.
Magnetic Resonance Imaging (MRI) scans
An MRI scan is not necessarily required, but it can be helpful in checking the condition of ligaments, tendons, and tissues that may have been damaged during the shoulder dislocation.
How to Treat a Dislocated Shoulder
When treating a dislocated shoulder, you should begin with non-surgical methods if the pain is manageable. However, if your shoulder dislocation causes you a lot of pain or instability, you should opt for shoulder surgery.
Treating a Dislocated Shoulder without surgery
There are many non-surgical methods to treat a dislocated shoulder.
Closed Reduction
The first step in treating a dislocated shoulder is closed reduction or repositioning. This treatment involves pushing back the humeral head into its initial position within the glenoid. The process can be done manually or by referring to the X-ray scan of your shoulder to ensure the realignment is done correctly. Do not attempt shoulder reductions yourself. A trained medical professional, such as a physician or an orthopaedic specialist, must perform this treatment.
Immobilisation
Once your shoulder has been repositioned, your doctor may put it in a sling or a splint to hold it in place. The purpose of immobilising your shoulder is to let it rest and accelerate recovery. Depending on the severity of your injury, you may have to immobilise your shoulder for a few days to a few weeks. Your doctor may also recommend at-home care, such as icing your shoulder and doing light exercises to keep the shoulder muscles from tightening.
Physical Therapy
Physical therapy or rehabilitation is essential to help you rebuild strength and improve your shoulder’s ability to move. After the pain and swelling of your shoulder have subsided, your doctor may assign a physical therapist to guide you on a range of safe and gentle-motion exercises to restore your shoulder function. Depending on the extent of your injury, you may need to attend rehabilitation for a few weeks to a few months.
Medication
In recovering your shoulder, you may be required to take medication to manage and reduce the pain. Your doctor may prescribe you pain relievers such as aspirin, ibuprofen, naproxen sodium, acetaminophen or something stronger, such as tramadol. Be sure to follow your doctor’s advice and stop taking medication when the pain has improved.
Treating a Dislocated Shoulder with surgery
Arthroscopic Shoulder Surgery
If your shoulder dislocation is severe and causes you immense pain or instability, surgical methods may be necessary. Treating a dislocated shoulder with surgery is the last resort if closed reduction is insufficient or if the surrounding blood vessels and muscles are extensively damaged. If you have had a previous shoulder injury at the same shoulder, surgery can help to repair and tighten the ligaments around the shoulder to keep your arm attached to the shoulder blade.
Depending on the severity of your shoulder dislocation, your doctor may recommend different types of arthroscopic or even open surgery.
How to Prevent a Dislocated Shoulder
If you have had a dislocated shoulder before, you may be at risk of experiencing another dislocation or injury at that same shoulder. Therefore, taking the proper steps to prevent another shoulder injury is crucial.
Safety measures
- Ensure your home and workspace are safe and clutter-free to avoid risks of tripping and falling.
- Avoid lifting heavy objects or doing activities that require extensive motions and movement.
- Use assistive devices such as canes or walking sticks if you have an increased risk of falling.
During physical activities
- Do proper stretches, such as having warm-up and cool-down routines before and after exercising.
- Wear protective gear such as shoulder braces and wraps as your doctor advises.
- Do not push your limits. If your shoulder starts to hurt during or after physical activities, stop and get some rest!
Frequently Asked Questions (FAQ)
A dislocated shoulder usually heals in a few weeks. However, if you plan to return to strenuous activities and sports, you may need to rest for six weeks to 3 months for complete recovery. This also depends on how effective and frequent your treatment is.
Try to avoid putting any weight on your affected shoulder. You can do this by sleeping in a reclined position on a reclining chair or placing your arm on a 45-degree wedge pillow. Another way is to sleep on your uninjured side, putting a few pillows behind your back to prevent yourself from rolling over.
No, a shoulder dislocation is not a chronic condition. However, delayed medical attention and repeated dislocations at the affected shoulder can lead to chronic shoulder instability.
Related Conditions
Biceps tendonitis is the inflammation of the upper part of the biceps, typically caused by overuse or injury to the biceps tendon. This tendon is a strong connective structure that connects the biceps muscle to the shoulder socket; while strong, overuse or injury can still cause gradual wear and tear, leading to inflammation and other complications.
The rotator cuff consists of several muscles and tendons surrounding the shoulder joint. It helps to stabilise the joint, allowing you to move your arms and lift objects.
