By Ehren Allen, DPT/Certified Orthopedic Manual Therapist
I remember watching Lethal Weapon back in the 80’s and seeing Mel Gibson purposely dislocate his shoulder too 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 is works in real life. Let me explain.
What is a Shoulder Dislocation?
The quick answer is that the shoulder is out of socket with a shoulder dislocation. The shoulder is a very mobile joint. It works like a ball and socket. The socket is very shallow in the shoulder. This allows a lot of mobility but is makes the shoulder less stable than other joints in the body. The shallow socket makes the shoulder more vulnerable to dislocation than other joints.
When the shoulder comes out of socket, it can come out all the way or only partially. If the shoulder comes out of 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 in to 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 as a result of trauma such as falling on an outstretched arm.
The shoulder is a shallow ball and socket joint. There are muscles and ligaments that 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 the bleechers of a stadium. 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.
How Do You Know if Your Shoulder is Dislocated?
There are several symptoms that may indicate that the shoulder is dislocated. These Include:
- Obvious deformity of the shoulder
- Severe Pain
- 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 how to fix 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?
When the shoulder dislocates anteriorly (to the front), the front part of the joint can become damaged. This may include torn ligaments and cartilage or labrum. This is called a Bankart Lesion. If the front of the labrum tears, it may need to be reattached to the socket of the shoulder. If this happens, an orthopedic surgeon will reattach the front of the labrum 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 afterward to help restore proper movement and function in the shoulder.
What Do I Do if I 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.
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. We offer ASAP appointments so that you can be seen quickly. We also offer the area’s top Rehabilitation Centers in 12 locations for your convenience. Let the Doctors and Therapists of JOI get you on the Road to Recovery! Go to JOI4U to learn how we are keeping you safe during COVID-19.
To schedule an appointment with a JOI Orthopedic Shoulder Doctor, call JOI-2000, schedule online, or click the link below.