Shoulder Dislocation

Do you remember watching Lethal Weapon back in the late 1980’s? Do you remember the scene when Mel Gibson dislocated his shoulder and then reset his injury by pounding his shoulder into the office filing cabinet? After becoming a nurse practitioner, I learned why resetting a dislocated shoulder without medical attention is not a great idea! To find out why, read the information below.

Causes

● Falling accidentally
● Trauma from playing sports (football, basketball, baseball, soccer, etc.)

Symptoms

● Hearing and feeling a pop in the shoulder
o It occurs when the head of the humerus comes out of its socket, the glenoid.
o The affected shoulder will be visibly out of place.
● Increased pain
● Increased shoulder weakness
● Decreased shoulder mobility
● Swelling
● Bruising
● Muscle spasms
● Numbness, tingling in the arm, back, and fingers

Treatment

● If you or someone else dislocates a shoulder, do not move the arm.
● Go directly to the ER or call 911.
● Do not try to reset the shoulder on your own.
o Doing so may cause severe damage to the nerves, blood vessels, muscles, and ligaments.
● Apply ice packs to the shoulder to help reduce swelling and pain.
● NSAIDS (Advil, Aleve, or Tylenol) will be helpful for pain relief.

Diagnosis

● Shoulder X-ray
● 2-view shoulder MRI/CT with contrast to show damaged ligaments that may be torn with the shoulder dislocation

Treatment

● The most important treatment for acute shoulder dislocation is immediate reduction of the glenohumeral joint.
o The glenohumeral joint is the most dislocated joint in the body.
o Shoulder dislocations can occur anteriorly (front), posteriorly (back), inferiorly (towards the armpit), and anteriorly-superiorly (direction: front and upwards).
o This will occur because of a complete rotator cuff tear and the ligament is no longer attached, or from an unsuccessful shoulder surgery.

o Patients with a previous shoulder dislocation are more likely to dislocate their shoulder again because the tissue does not properly heal or because the tissue becomes too laxed.
o The shoulder stability is maintained by the glenohumeral ligaments, joint capsule, and rotator cuff muscle.
o The inferior glenohumeral ligament is the most important and the most injured during an anterior shoulder dislocation.

▪ In this type of dislocation, the ligaments are torn off the bony attachments, and fractures to the glenoid or humerus may have occurred.
▪ Rotator cuff tears can also lead to shoulder instability, especially large rotator cuff tears.
▪ Shoulder instability can also be caused by a damaged nerve that controls the shoulder muscles.

Recovery

● Recovery time for a dislocated shoulder takes several weeks to several months depending on the severity and if surgery was needed.
● Please follow the directions of your orthopedic surgeon and physical therapist for a healthy recovery.