The orthopedic staff at Hand to Shoulder Center in Appleton or Green Bay is here to diagnose and treat your shoulder dislocation injuries. Contact Hand to Shoulder Center of Wisconsin today to learn more about our skilled team of therapists and orthopedic specialists.
The shoulder is the most mobile joint in the body, making it susceptible to injuries. Its complex design of the ball and socket joint allows for full range of motion allowing the hands to reach overhead, out to the side and behind the back.
Shoulder dislocation is an injury that occurs to the upper arm. The injury occurs when the upper arm bone (ball or head of the humerus) pops out of the shallow socket causing the shoulder joint to dislocate. The shoulder can dislocate forward (anterior), backward (posterior), or downward (inferior). Typically most dislocated shoulder injuries occur on the front (anterior) part of the shoulder. In addition to the shoulder dislocation, the shoulder capsule which is the fibrous tissue that joins the shoulder bones together, may be stretched or torn, resulting in shoulder instability. Nerves can sometimes be irritated, which can further complicate the injury.
Typically, shoulder dislocation causes are often related to trauma such as motor vehicle accidents or falls. In cases of contact sports, such as football and hockey, where direct blows are endured, shoulder dislocations are fairly common. Sometimes shoulder dislocations can also occur in patients with more laxity or global “looseness” in their joints. In these types of patients, non-traumatic activity, such as raising an arm or rolling over in bed, may result in a dislocation. This occurs in patients with abnormally loose ligaments which is sometimes due to an inherited condition.
Young adult males and older women tend to be at higher risk for shoulder dislocations.
Symptoms of Shoulder Dislocation
Shoulder dislocation symptoms may include:
- Shoulder bruising and swelling (possible abrasions if an impact has occurred from an injury)
- Shoulder deformation or out-of-place shoulder
- Mild to intense shoulder pain
- Limited or inability to move shoulder joint
- Possible muscle spasms
Diagnosis and Treatment
At Hand to Shoulder Center of Wisconsin, a thorough medical examination is performed by one of our experienced hand surgeons. Health history is discussed and carefully explored which includes prior shoulder and arm injuries, genetic medical conditions, and how the shoulders have been used. A physical and visual examination will detect swelling, tenderness, abrasions, and any deformity that may present. Arm mobility, active and passive range of motion are measured on the affected and opposite shoulder. In addition, with the many blood vessels and nerves traveling through the shoulder region, muscle and pulse strength along with numbness in the upper arm are tested.
X-rays may be ordered to confirm the diagnosis and reveal broken bones or additional damage to the shoulder joint.
Non-surgical and surgical treatment for a dislocated shoulder:
- Closed reduction – this involves the physician gently maneuvering your shoulder bones back into their normal position. Depending on the pain level and/or muscle spasms, a muscle relaxant may be administered. If the pain level is extreme, a general anesthetic may be used. Once your shoulder is back into position, shoulder pain often dissipates.
- Surgery – in rare cases, shoulder surgery may be needed to repair the damaged portion of the shoulder that supports the joint.
In closed reduction or shoulder surgery, immobilization is an important factor in the healing process followed by the initiation of a physical or occupational therapy program. A sling is designed to keep your shoulder from moving. Depending on the degree of injury and the procedure performed, splint immobilization will vary (Fig. 1). In most closed reduction cases, one to four weeks is standard.
In addition to wearing the sling, a dislocated shoulder rehabilitation program is vital for proper healing and return to function. At Hand to Shoulder Center of Wisconsin, a licensed physical or occupational therapist will work directly with you on a hands-on therapy treatment plan to restore range of motion, strength, and stability to the shoulder joint.
The rehabilitation exercises emphasize restoring range of motion in the uninjured portion of the shoulder and improving rotator cuff and scapular stabilizer control. Strengthening exercises further improve the dynamic stability of the shoulder; enabling you to move more smoothly during your daily activities.