Shoulder Dislocation (Dislocated Shoulder, Glenohumeral Dislocation)

Risk factors for a shoulder dislocation include: Previous shoulder dislocation or subluxationParticipating in contact sports such as football, wrestling, and hockey Conditions involving loose joints, such as Ehlers-Danlos syndromePoor muscle tone Symptoms Symptoms include: Pain, often severeInstability and weakness in the shoulder areaInability to move the shoulderSwellingBruisingShoulder contour appears abnormalNumbness and tingling around the shoulder or in the arm or fingers DiagnosisThe doctor will ask about your symptoms and how the injury occurred, and will examine the injured area. Diagnosis is also based on the physical exam of your shoulder area. The doctor may do an x-ray to rule out a related fracture or damaged surrounding soft tissue and to see which direction the shoulder is dislocated. TreatmentDo not try to force the bones back into place. Seek medical care immediately. Delaying treatment increases the chance of permanent damage to the shoulder joint. Treatment includes: Closed reductionThe doctor will move the head of the humerus back into the shoulder joint socket by applying traction to your arm. You will be given pain medication before this procedure begins.ImmobilizationAfter the reduction, you will need to wear a sling or a device called a shoulder immobilizer to keep the shoulder from moving. The shoulder is generally immobilized for about four weeks, and full recovery takes several months.RestIt is important to rest your shoulder and not put any strain on the joint area.Ice and heatApply ice or a cold pack to your shoulder for 15-20 minutes, four times a day, for the first two days. After the third day, use a heating pad for 20 minutes or less might help relief muscle soreness. This helps reduce pain and swelling as well. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin.Rehabilitation exercisesAfter removal of the shoulder sling, begin exercises to restore strength and range of motion in your shoulder as recommended by your healthcare professional.Pain medicationsNonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen (Tylenol) help relieve pain.SurgerySurgery is rarely needed for a first time dislocation. It is often needed for a shoulder that dislocates repeatedly. Prevention To help prevent a shoulder dislocation:

Do exercises to strengthen the muscles around your shoulder.Wear proper safety equipment and padding for protection in sports.Avoid falls. RESOURCES: American Academy of Orthopaedic Surgeonshttp://www.aaos.org The American Orthopaedic Society for Sports Medicinehttp://www.sportsmed.org CANADIAN RESOURCES: Canadian Orthopaedic Associationhttp://www.coa-aco.org/ Canadian Orthopaedic Foundationhttp://www.canorth.org/ References: American Academy of Orthopaedic Surgeons website. Available at: http://www.aaos.org . National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/ . Quillen DM, Wuchner M, Hatch RL. Acute shoulder injuries. Am Fam Physician. 200415;70:1947-1954. Last reviewed November 2007 by John C. Keel, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.