The shoulder is relatively easy to dislocate because it can move in so many directions and is looser than most other joints. It can dislocate in any direction, but most commonly in the forward direction. A shoulder dislocation can result in injury to labrums, tendons or nerves.
There are two types of shoulder dislocation:
- Partial shoulder dislocation, also called subluxation, means the top of the humerus or “the ball” has only partially slipped out of the socket.
- Complete shoulder dislocation occurs when the head of the humerus is all the way out of the socket.
No matter what type, shoulder dislocations cause unsteadiness and pain in the shoulder. Other symptoms of a dislocated shoulder include:
- Shoulder weakness
In rare cases, a dislocated shoulder causes muscle spasms, which can make the pain even worse.
During your appointment, your Sports Medicine doctor will examine your injured shoulder. You should let your doctor know how you hurt your shoulder and if it has happened before.
Usually, your Sports Medicine doctor can set your shoulder back into place right in the office using a procedure called a closed reduction. A closed reduction is done by placing the head of the humerus back into its socket. After the shoulder is back in place, your pain will improve immediately. A reduction can also be performed in the emergency room or by your athletic trainer.
Depending on the injury’s severity, your doctor may immobilize your shoulder in a shoulder sling and ask you to start treatment by resting and icing your shoulder for a few days. After the pain and swelling has gone down, your doctor may refer you to a physical therapist, because in most cases people will develop tightness and weakness after a shoulder dislocation. A physical therapist can teach you shoulder exercises to strengthen the muscles and regain full range of motion. This may also help reduce your risk of dislocating your shoulder again later.
If you dislocate your shoulder repeatedly, you may have chronic shoulder instability.
Multidirectional instability is a condition in which repetitive strain on the shoulder can cause a loose joint and persistent pain. A common source of this kind of injury is repetitive overhead activity such as in volleyball, swimming and gymnastics. Symptoms can begin to surface during high-demand situations and over time begin to appear more regularly.
Some common chronic shoulder instability symptoms include:
- Recurrent shoulder dislocations or partial dislocation episodes
- Pain caused by repetitive shoulder movement
- Persistent feeling of looseness in the shoulder
When seeing your Sports Medicine doctor about your shoulder instability, tell him or her about your medical history, especially if you have dislocated your shoulder before. The doctor may also perform specific tests to see how unstable your shoulder is or if the ligaments in your shoulder are loose.
Multidirectional shoulder instability without trauma, a fall, or acute injury can usually be diagnosed without imaging and you may be first referred for physical therapy. If the doctor feels imaging is necessary, they will usually start out with X-rays and or an ultrasound image of you shoulder. If there is a history of trauma or if the doctor discovers something on the physical exam that raises concern of a possible injury deep in the shoulder joint, an MRI might be ordered.
Chronic shoulder instability is usually treated with non-surgical methods first, but it can take several months to tell how effective they are. Some recurrent shoulder dislocation treatment options include:
- Modified activities or rest away from sports to avoid worsening symptoms
- Non-steroidal anti-inflammatory medication to relieve pain and swelling
- Physical therapy to strengthen the shoulder muscles
If you are young and have a traumatic shoulder dislocation, you should see an Orthopedic Surgeon who may talk to you about surgery as possibly the best option. Even though your Sports Medicine doctor may start by using non-surgical treatments, shoulder instability surgery may be needed to repair the ligaments so they can hold the shoulder more securely in place.
Arthroscopic surgery for chronic shoulder instability is relatively minimally invasive, but some patients may need open surgery. No matter which type of surgery your Orthopedic surgeon recommends, expect a period of rehab to follow your surgery. You will start some physical therapy right away, but you will need to wear a sling for several weeks.