Shoulder Dislocation

What is a shoulder dislocation?

A dislocated shoulder is an injury in which your humerus (upper arm bone) pops out of the cup-shaped socket that's part of the scapula (shoulder blade). A partial dislocation means the head of the humerus is partially out of the socket. A complete dislocation means it is all the way out of the socket. The shoulder can dislocate forward, backward or downward. In some cases, dislocation may tear shoulder ligaments and tissue or damage nerves.

A shoulder dislocation is often confused with a shoulder separation. These are two different injuries. A shoulder separation occurs when the collar bone loses contact with the shoulder blade.

This figure shows the normal bony anatomy of the area. The red arrow points to the joint that comes apart in a shoulder separation injury.-Sources:AAOS

How does a shoulder dislocation occur?

The shoulder is the most frequently dislocated joint in the body. Dislocations are a common sports injury, especially in contact sports such as football and hockey, or sports that involve falls, such as downhill skiing, gymnastics and volleyball. Other causes include trauma, automobile accidents and household falls.

This figure shows the intact ligaments around the acromioclavicular joint. The red arrow points to the ligaments that are around the joint itself. The gray arrow points out the important stabilizing ligaments underneath the collarbone.-Source:AAOS

What are the symptoms of a shoulder dislocation?

Both partial and complete dislocation cause pain and unsteadiness in the shoulder. Other symptoms include:

  • A visibly deformed or out-of-place shoulder
  • Swelling
  • Bruising
  • Numbness, weakness or tingling near the injury
  • Inability to move the shoulder joint

How is a shoulder dislocation diagnosed?

In addition to a complete physical exam and patient history, and xrays of the dislocated shoulder can confirm diagnosis. MRI with dye injected in the joint (arthrogram) is used pre-operatively to confirm and delineate injury to the capsule, labrum and bone.

What is the treatment?

A dislocated shoulder requires prompt medical attention. Treatment options include:

  • Closed Reduction. In this procedure, your doctor gently maneuvers your shoulder bones back into place. When the bones are in their proper position, pain should subside. Conservative treatment such as ice and non-steroidal anti-inflammatory medications can reduce pain and swelling. Immobilization in a sling can help prevent further injury. Your doctor may recommend stretching and strengthening exercises to prevent recurrent dislocations in the future.
  • Surgery. Depending on the severity of your injury, surgery may be necessary to repair damage to the tissues surrounding the shoulder joint. If you have recurring dislocations (a condition known as shoulder instability), surgery is often recommended to tighten the capsular ligaments and repair the labrum surrounding the joint. This surgery is usually an arthroscopic procedure and patients go home the same day. Following surgery, patients typically keep the shoulder immobilized in a sling for several weeks and then undertake a rehabilitation program to restore range of motion, strength and flexibility while protecting the repair.

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