The head of the humerus (upper arm bone) sits in a shallow socket at the shoulder and is therefore liable to dislocation. Anterior dislocations account for around 95% of cases and involve the head of the humerus being forced forwards between a small gap in the surrounding ligaments when the shoulder is externally rotated (turned outwards) and abducted (held out to side of body). Of the remaining cases posterior dislocation is the most common. When the shoulder is dislocated surrounding structures may also be involved, most commonly the glenoid labrum. This is a ring of cartilage around the socket of the shoulder joint that functions to deepen the socket. Once the shoulder has been dislocated it is prone to reoccur.
Symptoms
On initial injury caused by a direct impact often with arm externally rotated and abducted:
- Pain that is sudden and severe
- Sense of shoulder ‘popping out’
- Shoulder looks different to other side with a loss of the rounded shape as seen from the front
- Individual usually holds arm close to body
- Pins and needles possible if nerves have been damaged during injury
What you can do
- The shoulder should be immobilised in a sling to prevent further damage
- Medical attention should be sought ASAP. DO NOT TRY RELOCATE YOURSELF as you may cause further damage. An x-ray is usually required to check for fractures before relocation.
- Following assessment and relocation the shoulder should be rested and immobilised for a week or longer if there have been complications e.g. muscle injury or fracture
What we can do
- Rehabilitation can be prescribed.
- The first stage is to use stretches to restore a full range of motion in the joint.
- The second stage is to restore control of movement.
- Once range of movement and control have been restored exercises can be given to build up strength in the muscles surrounding and supporting the shoulder
- Massage, myofascial release and stretches can be used to achieve full range of motion in the shoulder joint
