Shoulder Dislocations
The shoulder is the most commonly dislocated large joint in the whole body. This is because it is designed for maximum movement and is slightly compromised in terms of structural support to achieve that. If the supporting ligaments or the lining of the joint are injured, then the joint may completely or partly come out of joint (dislocated or subluxate). Alternatively if the supporting structures are more flexible than normal then this may also cause the shoulder to dislocate. Shoulder ‘instability’ also describes shoulder conditions without dislocation where there may be excess abnormal movement in the joint that causes symptoms of shoulder pain.
What are the causes of shoulder dislocation?
There are two main categories of dislocation:
1. Traumatic dislocation
The shoulder is injured with sufficient force to cause the shoulder to come out of joint. Common reasons for this are sporting injury e.g.: rugby, skiing. The shoulder may stay dislocated and may need putting back into joint in the hospital. Injuries to the shoulder causing dislocations damage the supporting structures inside the shoulder and weaken the shoulder. This may cause further dislocations in the future, even with very minor injury, or symptoms of pain due to instability without further dislocations. If you have dislocated your shoulder, call The Cheshire Shoulder and Elbow Clinic for an appointment to have a comprehensive assessment of your shoulder.
2. Dislocation without injury
This occurs when the shoulder subluxes or dislocates with minimal force when moving the shoulder in a certain way. It is usually painful but often the shoulder usually goes back into joint itself. This often occurs in people who have laxity of their joints (e.g.: being double jointed).
Treatment of shoulder dislocations
The emergency treatment is to relocate the shoulder into joint. Following a period of rest in a sling, physiotherapy is often helpful in helping to regain mobility and strength of the shoulder. Physiotherapy is also extremely helpful in treating patients whose shoulders initially dislocated with no or minimal trauma.
Surgery may be considered after the initial episode of dislocation or if the shoulder repeatedly dislocates (recurrent islocation). Surgery is also used to treat patients whose shoulders are unstable but that do not fully dislocate. The aim of surgery is to repair the damaged structures inside the shoulder and to return the patient to normal activities including contact sports. This is carried out using keyhole (arthroscopic) surgery and is often performed as a daycase (come into hospital and go home the same day).
If you have dislocated your shoulder and would like a shoulder assessment or further advice regarding treatment or return to sporting activities, call The Cheshire Shoulder and Elbow Clinic to book an appointment.