Shoulder Dislocation

By Ehren Allen, DPT/Certified Orthopedic Manual Therapist

Shoulder Dislocation

I remember watching Lethal Weapon back in the ’80s and seeing Mel Gibson purposely dislocate his shoulder to win a bet or get out of a straight jacket.  The movie depicted it well in that the pain was severe.  But recurrent shoulder dislocation causes more than just pain.  They are a sign of instability and possibly torn tissue in the shoulder.  Watching Mel slam himself into a wall to relocate the shoulder was great entertainment, but not quite how it works in real life. Let me explain.

Shoulder Dislocation on X-ray

Anterior Shoulder Dislocation

 

What is a Shoulder Dislocation?

The quick answer is that the shoulder is out of the socket with a shoulder dislocation.  The shoulder is a very mobile joint. It works like a ball and a socket.  The socket is very shallow in the shoulder.  This allows a lot of mobility but makes the shoulder less stable than other joints in the body.  The shallow socket makes the shoulder more vulnerable to dislocation than other joints.

image of bones of the shoulder

Image of the bones of the shoulder

When the shoulder comes out of the socket, it can come out all the way or only partially.  If the shoulder comes out of the socket partially, this is called a subluxation.  With a subluxation, the ball or head on the humerus (arm bone) pops out partially but usually pops right back into the socket.  This can still be very painful.  If the head of the humerus pops all the way out of the socket, this is called a dislocation.  If the shoulder is fully dislocated, it may not pop back in on its own. A dislocated shoulder may require a doctor to help relocate or reduce the dislocation.

 

Are There Different Types of Dislocated Shoulders?

The shoulder can dislocate in several directions.  These include:

  • Anterior Dislocation (to the front)
  • Inferior Dislocation (downward)
  • Posterior Dislocation (to the back)

The most common type of shoulder dislocation is to the front.  Most of the time, a dislocation of the shoulder happens due to trauma, such as falling on an outstretched arm.

Anatomy of the Shoulder for a shoulder dislocation

Shoulder Anatomy

The shoulder is a shallow ball and socket joint. Some muscles and ligaments help to hold it together.  There is also a labrum that helps to make the socket deeper and stabilize the joint. The labrum is made up of ligament and cartilage and looks kind of like a stadium’s bleachers.  When the shoulder dislocates, the labrum can tear.  With severe dislocation, there may be a fractured bone as well.  Dr. Carlos Tandron of the Jacksonville Orthopedic Institute states that labral tears are more common in the younger population in general.

To learn more about the Anatomy of the Shoulder, this VIDEO may help.

Click HERE to watch Dr. Kaplan’s  Shoulder Dislocation Video.

How Do You Know if Your Shoulder is Dislocated?

Bike accident with a shoulder dislocation

Shoulder injury after a bike accident

Several symptoms may indicate that the shoulder is dislocated.  These include:

  • Obvious deformity of the shoulder
  • Severe Pain
  • Numbness
  • Discoloration or bruising
  • Swelling in the shoulder or arm

Some of these symptoms may be present with other shoulder issues as well.  Remember that most of the time, dislocations initially occur with trauma.

To learn more about Shoulder Symptoms, read this Article on 5 Shoulder Symptoms You Should Not Ignore.

 

How Do You Fix a Dislocated Shoulder?

A dislocated shoulder is a medical emergency.  If you are concerned that you may have a shoulder dislocation, go to the Emergency Department.  There are videos and instructions online about fixing it yourself, but this is a BAD IDEA!  If the shoulder is dislocated, there could also be a fracture or a compromised nerve or blood vessel.  Trying to fix it yourself can result in serious medical issues.  Remember, Mel Gibson was an actor.

 

What is a Bankart Repair?

image of bankart repair surgery

Bankart repair is used to reattach the cartilage in the front of the shoulder

When the shoulder dislocates anteriorly (to the front), damage occurs to the front of the shoulder complex.  This may include torn ligaments and cartilage or labrum.  This is called a Bankart Lesion.  If the front of the labrum tears, surgery to repair the labrum is what you may need.  If this happens, an orthopedic surgeon will reattach the labrum’s front back in place using anchors and sutures. This is known as a Bankart Repair. A Bankart Repair can help to keep the shoulder from dislocating again.  It also helps the shoulder to function better.

If a Bankart Repair is performed, the patient will require Rehabilitation to restore proper movement and function in the shoulder.

What Do I Do if  My Shoulder Dislocates?

The quick answer is to seek medical treatment quickly.  If you go to the Emergency Department, they will relocate and probably refer you to an Orthopedic Surgeon.  If your shoulder dislocates more than once, it means that the shoulder is unstable, and you need to see a Shoulder Orthopedic Doctor.  You may need therapy to increase the strength around the shoulder. Sometimes, surgery is needed to make the shoulder more stable.

Therefore, if you have shoulder problems, the Jacksonville Orthopedic Institute can help!  We have the top Orthopedic Shoulder Doctors in Northeast Florida, and we are here for you.

Related Videos: Shoulder Pain Can’t Wait, Proximal Humerus Fractures. and Anatomy of the Shoulder. 

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