Of all the joints in the body, the shoulder is by far the most mobile. Being a ball and socket joint, it is capable of moving in more directions than any other joint in the body. Whilst this gives us the ability to interact with the world with our hands, it also means that the shoulder is more prone to dislocating.
What is a shoulder dislocation?
Quite simply, a shoulder dislocation happens when the bone of your upper arm (humerus) pops out of its socket (not so humerus). Whilst dislocations can happen in any part of the body, the shoulder is most at risk because it is also the most mobile joint (that is, it can move in more directions than any other joint). There are three main ways a shoulder can be dislocated, as described below.
In an anterior dislocation, the humerus dislocates in a forwards direction relative to the shoulder socket (i.e., anteriorly), and is the most common way to dislocate a shoulder. Up to 95% of all shoulder dislocations are anterior dislocations! These dislocations are usually caused by falling on an outstretched arm, or a direct blow to the shoulder from the side.
Posterior dislocations happen in the opposite direction to anterior dislocations – the upper arm bone pops out backwards relative to the shoulder socket. These are much less common than anterior dislocations and tend to happen due to extreme contractions of the muscles on the back of the shoulder (e.g., as a result of being electrocuted or during a seizure).
These dislocations are very rare and only happen around one percent of the time. Interestingly, when the shoulder dislocates downwards, the rest of the humerus actually sticks upwards or behind the head due to the way the dislocation happens. Inferior dislocations tend to be cause by sudden forceful movement of the arm sideways and upwards.
What should I do with a dislocated shoulder?
With any shoulder dislocation, you should seek out prompt medical treatment as there is a strong risk of damaging important structures in and around the shoulder, including blood vessels and nerves. Do not attempt to relocate the shoulder by forcing it back into position as this may result in further injury. Keep the shoulder in its current position by using a sling or splint. Anterior dislocations may spontaneously relocate, but it is still advisable to seek medical treatment to ensure other structures are not affected.
For some, physiotherapy treatment alone can be sufficient to regain full shoulder function. This is usually advised when the extent of the injury is minor, meaning that there is no compromise of the nerves and blood vessels, and minor or no injury to the soft tissue and bones of the shoulder socket and humerus. In the early stages of treatment, you may be required to limit movement by wearing a sling to allow the injury to settle. This is then followed by gradual shoulder strengthening and stabilisation exercises to restore range of motion and control.
Surgical management is sometimes necessary for more serious shoulder dislocations, or where the shoulder is involved in high-performance activities such as sports. A “keyhole” or arthroscopic approach is usually used. In some cases, people may have recurrent shoulder dislocations as the initial dislocation makes the shoulder “loose”. People with recurrent dislocations may also be good candidates for surgery as this can help to stabilise the shoulder further.
Whether the surgical or non-surgical route is taken, physiotherapy and an exercise-based treatment program are recommended to ensure that strength, range and function of the shoulder is restored.
I’d like to get in touch about my shoulder!
If you have concerns about a shoulder dislocation, whether it’s a new injury, recurrent or post-surgical, we’ll be happy to help! Give us a call on 1300 738 609 or book online to see one of our physiotherapists and we’ll be happy to work with you. Let us help you find your Solution.