The shoulder joint is built for mobility and free moving function. This mobility range comes at a price and that price is that the joint is vulnerable to shoulder dislocation. In simple terms dislocation of the shoulder occurs when the ball of the upper end of the arm bone no longer fits snuggly in the socket of the shoulder blade.
Subluxation of the shoulder is a more subtle form of shoulder problem when the ball is not fully out of its socket but either is too mobile in the joint or is partly sitting outside the normal ball and socket alignment.
Shoulder dislocation can be the result of an accident such as a motor vehicle collision, a sporting activity, or a fall onto an outstretched arm. Recovery from a dislocated shoulder can take months before normal function is regained
Dislocation of the shoulder can happen when a strong force, such as a traumatic injury, abnormally stretches the ligaments and tendons, causing the ball-shaped end of the humerus to pop out of its socket.
A small minority of people have shoulder joints that can sublux or even dislocate spontaneously.
Nearly all shoulder dislocations result from a sudden wrenching movement or from falling onto an outstretched arm or from sudden traumatic impact such as in a road accident.
The ball of the head of the humerus bone nearly always dislocates in to the front or to the back of the shoulder. These are called anterior shoulder dislocation and posterior shoulder dislocation respectively.
Dislocation downwards - called inferior shoulder dislocation - is much less common
A sudden dislocation such as in sport or a fall causes immediate and intense severe pain.
For some people the pain of acute shoulder dislocation can be relatively mild as long as they keep their arm still.
Bruising, swelling, weakness, tingling, and numbness often occur.
Chronic subluxation or recurrent shoulder dislocations may be much less painful. This pattern usually happens against a background of lax shoulder ligaments and a history of a previous initial acute severe dislocation.
An experienced doctor or therapist can often make the diagnosis of shoulder dislocation based on the history given by the patient and on the examination findings. If the shoulder dislocation has happened to the front then the ball of the head of the humerus can sometimes be felt beneath the skin.
X-rays will be taken to confirm the diagnosis and to exclude a fracture of any of the shoulder bones.
MRI scan is often required in cases of recurrent dislocation or subluxation
In acute shoulder dislocation the patient should attend the emergency department of the nearest hospital as quickly as possible after the accident.
X-rays will be taken to rule out a fracture.
A light sedation will be given while one of the doctors attempts to put the shoulder dislocation back into place. This procedure is called "reduction of the shoulder"
The relocation or reduction procedure is sometimes straightforward but it can at times be very difficult and you may need to go to the operating room for general anesthesia.
Once the shoulder is back in place then you should try to use it as normally as possible - although this may be very shoulder to begin with. Try to avoid the temptation to use a sling since this will simply lead to weakness of the muscles.
You will need to visit an orthopaedic specialist some time after your shoulder dislocation to determine if any further treatment is required and to assess whether the shoulder is stable or unstable in its movements
The risk of further shoulder dislocation is in part related to your age at the time of the first injury. If you are young then it is highly likely that you will experience another episode. If you are over the age of forty then the chance of further dislocation problems is much less.
Some patients who develop chronic instability of the shoulder eventually need to have an operation to stabilise and strengthen the joint
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