(Dislocated Shoulder; Glenohumeral Dislocation)
DefinitionA shoulder dislocation occurs when the head of the humerus (upper arm bone) pops out of the shallow shoulder socket of the scapula (called the glenoid). This can happen when a strong force pulls the shoulder upward or outward, or from an extreme external rotation of the humerus.Glenohumeral dislocations are generally classified by the direction of dislocation of the humerus.Dislocation can be full or partial:
- Partial dislocation (also called subluxation)—the head of the humerus slips out of the socket momentarily and then snaps back into place
- Full dislocation—the head of the humerus comes completely out of the socket
|Copyright © Nucleus Medical Media, Inc.|
CausesShoulder dislocation can be caused by:
- Falling on an outstretched arm
- A direct blow to the shoulder area, such as in automobile accident
- Forceful throwing, lifting, or hitting
- Force applied to an outstretched arm, such as in a football tackle
Risk FactorsFactors that may increase your chance of a shoulder dislocation include:
- Previous shoulder dislocation or subluxation
- Participating in contact sports such as football, wrestling, and hockey
- Conditions involving loose joints, such as Ehlers-Danlos syndrome
- Poor muscle tone
- Pain, often severe
- Instability and weakness in the shoulder area
- Inability to move the shoulder
- Shoulder contour appears abnormal
- Numbness 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.
Initial CareSeek medical care right away. Do not try to put your shoulder bones back into place. If you wait for treatment, you could cause permanent damage.The 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. After 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 4 weeks, and full recovery takes several months. Surgery is rarely needed for a first time dislocation. It is often needed for a shoulder that dislocates repeatedly.
Rest and RecoveryIt is important to rest your shoulder and not put any strain on the joint area. This will require a reduction in activities while your shoulder heals. However, complete rest is rarely required. Ice and elevating your arm at rest may also be advised to help with discomfort and swelling. Ask your doctor when you can switch from ice to heat.As you recover, you may be referred to physical therapy or rehabilitation to start range-of-motion and strengthening exercises. Do not return to activities or sports until your doctor gives you permission to do so.Your doctor may advise nonsteroidal anti-inflammatory drugs (NSAIDs) to help relieve inflammation and pain.
PreventionTo help reduce your chance of a shoulder dislocation:
- Do exercises to strengthen the muscles around your shoulder
- Wear proper safety equipment and padding for protection in sports
- Avoid falls
Ortho Info— American Academy of Orthopaedic Surgeons
Sports Med—American Orthopaedic Society for Sports Medicine
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Dislocated shoulder. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00035. Updated October 2007. Accessed December 17, 2014.
Quillen DM, Wuchner M, Hatch RL. Acute shoulder injuries. Am Fam Physician. 2004;15;70:1947-1954.
Shoulder dislocation. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 9, 2014. Accessed December 17, 2014.
Shoulder problems. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health%5FInfo/Shoulder%5FProblems/default.asp. Updated April 2014. Accessed December 17, 2014.
- Reviewer: Michael Woods, MD
- Review Date: 12/2014
- Update Date: 12/20/2014
Many medical groups felt that early exposure to certain foods like peanuts increased a child's risk of developing food allergies. However, newer research including this trial suggest that early exposure may actually decrease the risk of developing food allergies.
Breastfeeding May Decrease the Risk of Childhood Obesity
Tonsillectomy May Reduce Number of Sore Throat Days in Children
Research Review Finds Little Support for Nearly Half of Medical Talk Show Recommendations