Shoulder dislocation

15 shoulder 3D animated models are available to view for shoulder related conditions, diseases, pains and injuries, which can be found listed under ” Pain Management,” “Orthopaedics” and “Complementary Medicine” in our Videos Library section. Also in this library there are a further 100 3D animated videos covering other conditions /complaints under the same headings. To view the Videos Library return to our home page, click on the Videos Library section which is positioned in the top right hand corner.

Shoulder Dislocation.

What is it?

Shoulder dislocations occur when the head of the humerus which is the upper arm bone, jumps out of the shoulder socket of the scapula, which is called the glenoid. This can happen during a severe wrench pulling the shoulder upward or outward, or from a combined over-extension and external rotation of the humerus.

Glenohumeral dislocations are generally classified by the direction of dislocation of the humerus.

A dislocation can be full or partial:

• A partial dislocation which also known as subluxation, when the head of the humerus slips out of the socket momentarily and then snaps back into place (socket)
• A full dislocation, when the head of the humerus comes completely out of the socket

Shoulder dislocations are normally associated with fractures to different parts of the shoulder; there may be a fracture and dislocation at the same time. Nerves and blood vessels can sometimes be injured with a severe shoulder dislocation.

Types of Shoulder Dislocation:

• Anterior
  when the humeral head moves forwards. This is a very common injury in young men. Men having great shoulder flexibility are more prone to this injury.
• Posterior
  when the humeral head moves backwards. This is due to severe muscle spasm during an electric shock or epileptic seizure.
• Multidirectional
  this occurs in people born with loose joints. Muscles contracting and relaxing may trigger a multidirectional instability episode. Also certain sports that require greater shoulder range of motion such as swimming may also lead to multidirectional instability.

Shoulder instability usually results from an old injury producing a dislocation that, even when healed, leads to stretching of the shoulder capsule and ligaments

How does it happen?

When forces acting on the shoulder joint are too great for the supporting muscles and ligaments to withstand, then top of the arm bone may be caused to ‘pop out’ or dislocate. This can occur with a direct blow to the shoulder joint which pushes the ball-shaped top of the arm bone out of its socket. Alternatively, it may result from the transmission of forces up the arm to the shoulder joint. For example, when you land on an outstretched hand, forces can be transmitted up the arm to the shoulder joint causing it to dislocate.

Causes

• Falling on an outstretched arm
• A direct or powerful blow to the shoulder area.
• Repetitive sports or activities such as throwing or lifting

Any kind of force applied to an outstretched arm.

How does it feel?

The first sensation felt when the shoulder is dislocated is immediate and intense pain. This is often felt all over the shoulder and may also radiate down the arm. It is usually so intense that you hold your arm against your body with your other arm. At the time of injury you may have also sensed the shoulder ‘popping out’. This ‘popping-out’ or dislocation of the joint is often visible when you compare the appearance of the injured shoulder to the opposite side.

Symptoms

•   Swelling
•   Bruising
•   Pain (often severe)
•   Shoulder contour appears abnormal
•   Bruising Instability and weakness in the shoulder area
•   Inability to move the shoulder
•   Bruising Instability and weakness in the shoulder area
•   Numbness and tingling around the shoulder or in the arm or fingers
•   Seek immediate medical attention.

What should you do?

A shoulder dislocation is a serious injury which requires urgent medical attention. If you have or suspect you have dislocated your shoulder you should stop all activities and seek medical advice from a Chiropractor or Physiotherapist or Doctor. A sling will be needed to support the arm; in emergency a homemade sling will do by using a jumper or towel. To help with your pain and reduce and control any swelling you should also apply an ice pack to the shoulder, a thin cloth should be placed onto the injured area, the ice pack to be placed directly on top of the thin cloth, and this should be applied for up to 15-20 minutes once an hour.

What shouldn’t you do?

If you have or suspect you have dislocated your shoulder, the main thing you shouldn’t do is try to ‘reduce’ or relocate the top of the arm bone back into its socket by yourself. This requires a Chiropractor or Physiotherapist or Doctor. If not done properly serious damage may be done to other structures (nerves, bones, ligaments, cartilage) resulting in irreparable damage and/or a longer recovery time. In addition, you shouldn’t undertake any activities which increase blood flow to the injured site. These include hot bath and showers, heat packs and rubs, and massage therapy. These will cause further swelling in the damaged tissues resulting in a prolonged recovery.

Could there be any long-term effects?

Due to the seriousness of a shoulder dislocation, there are unfortunately potential long-term effects. The most common of these is recurrent or ongoing shoulder dislocations. When the shoulder joint is dislocated, the tissues which support it are overstretched and in some cases torn. This makes the joint less stable and decreases its ability to resist or withstand external forces. As a consequence, it dislocates much more easily. Other long-term effects result from damage to surrounding structures when the shoulder joint is dislocated. Occasionally, when the shoulder joint is dislocated, nearby nerves may be damaged. This can result in numbness or altered sensation over the outside of the shoulder and occasionally weakness in the shoulder muscles. This can prolong your recovery. Similarly, recovery may be prolonged if a bone is fractured or broken when the shoulder is ‘popped out’.

Treatment Options

• Cold or Low Level Laser Therapy, this modality has a five star rating for accelerating the healing process by significantly reducing swelling and inflammation, to the injured area and thus providing significant pain relief.
• Rest and limit activity of the shoulder joint
• Ice packs will help control pain
• Nonsteroidal anti-inflammatory drugs These include: aspirin, ibuprofen (Motrin, Advil)

Management

The advice and assistance from a Chiropractor or Physiotherapist or Doctor is important in the treatment of a dislocated shoulder. Initially, they can confirm that the shoulder is actually dislocated. If it is, they can assist in relocating or ‘reducing’ the bones back into their normal position. Following this, they can assess which tissues have been damaged and the extent of this damage. This may require the use of a Digital-x-ray to determine whether any of the bones are damaged. After this is done a Chiropractor, Physiotherapist or Doctor will be able to provide you with a determination of how long the injury is expected to take to heal.

For healing this injury ideally Cold or Low Level Laser Therapy should be administered, this modality accelerates the healing process in the area of the joint, capsule and ligaments, reducing swelling and inflammation, thus bring significant pain relief, a five star rating has been awarded to this modality, (more information can be found on this laser modality, under our “Pain Relief” section). A sling should be used immediately after the injury, for at least two to three weeks. A series of exercises should be undertaken designed to return you back to normal and sporting activities; these will reduce the risk of further shoulder dislocations.

Rehabilitation

Can last several months and may include: physical therapy to strengthen the muscles that control the shoulder joint.