Shoulder Dislocation

The shoulder is your body’s most dynamic joint. But being the most mobile and flexible joint comes with a unique risk: it is more susceptible to dislocation.

Shoulder dislocation is usually the result of instability in the connection between the humerus and the shoulder’s ball-and-socket joint, the glenoid. A tear in the labrum, which is the cartilage that lines the glenoid, is the most common reason for instability and dislocation. For some people, however, the instability is a chronic condition in which the labrum isn’t actually torn, but the shoulders are loose and the joint isn’t held in place securely.

Anterior shoulder dislocations are most common. People with anterior dislocations often have a sensation that their shoulder is out of joint. The shoulder can dislocate in virtually any direction: forward, backward, or downward.

Dislocated Shoulder Types

A shoulder doesn’t always fully dislocate. In fact, there are two types of shoulder dislocation:

• Complete dislocation: The humerus is fully out of the glenoid socket. This type of dislocation is almost always the result of blunt trauma like a fall, an accident, or a sports injury. This can potentially tear shoulder ligaments or tendons and cause nerve damage.
• Subluxation: Partial dislocation—the head of the humerus is not fully out of socket. This is often a more chronic condition precipitated by shoulder instability, but people with subluxation are also more prone to complete dislocation.

Dislocated Shoulder Symptoms

• Shoulder pain, possibly radiating down the arm
• Shoulder visually lower than the other
• Bruising
• Inflammation
• Weakness in the arm

Diagnosing a Dislocated Shoulder

• An X-ray is used to determine the location of the dislocation and to look for fractures
• An MRI arthrogram can assess the labrum and rotator cuff for tears
• Occasionally, a CT scan may be ordered to evaluate for hairline fractures or other bone injuries

Treatments for Shoulder Dislocation

• A reduction (the term for putting the shoulder back into place by moving the humeral head back into the proper position) is performed under sedation by a doctor.
• After the reduction, ice should be applied four times per day and a sling will be used to immobilize the shoulder for several weeks.
• For major fractures and labral or rotator cuff tears, surgery may be recommended. Types of surgery may include:
  • Labral repair (Bankart repair)
  • Capsulorrhaphy (ligament repair and tightening)
  • Humeral allograft reconstruction
  • Glenoid allograft reconstruction
• Rehab exercises will help restore strength and range of motion and muscle strength after reduction or surgery. In most cases, rest and protection in a sling is recommended for a few weeks followed by a course of physical therapy.

Recovering from Post-Dislocation Surgery

• Usually the surgery is an arthroscopic, outpatient procedure with patients going home on the same day.
• Patients wear a sling for about one month after surgery.
• Patients need physical therapy for about four months to recover strength and range of motion.
• Athletes can return to their sport in about six months.