Shoulder Dislocations
Dislocation of the shoulder is an immensely painful injury that can be felt as soon as the injury takes place. Shoulder dislocation occurs when the ball/head of the humerus detaches from the socket joint of the scapula. The shoulder is one of the most likely joints to be dislocated.
The clavicle (collarbone) attaches to the sternum (chest) and the scapula (shoulder blade). The clavicle attaches to the acromion (the front of the shoulder) through the acromioclavicular joint. The scapular spine houses the pectoral muscles and the glenohumeral joint (the ball and socket portion of the shoulder) at the front of the shoulder. The rotator cuff beneath the acromion and the bursa houses many tendons and muscles that allow for the dexterity of movement with the shoulder.
The rotator cuff refers to the group of muscles and tendons that surround the ball-and-socket joint of the shoulder where the humerus meets the scapula. There are four muscle tendons that make up the rotator cuff. These muscles are the supraspinatus, infraspinatus, teres minor, and subscapularis. The subscapularis is located at the back of the shoulder by the scapula and attaches the scapula to the rotator cuff.
Shoulder dislocation is a serious injury that occurs when the upper humerus pops out of the socket of the scapula or is misplaced. Ultimately, the head of the humerus and the socket of the scapula are separated with the ball (head) of the humerus out of position. In addition, the muscles, ligaments, and tendons of the shoulder joint are often injured in conjunction with a shoulder dislocation.
Shoulder dislocations are usually caused by hard falls or forceful blows to the shoulder. This most often occurs during recreational activities and contact sports. Dislocated shoulders have been known to be most common in teens and young adults. The shoulder has a wide range of motion, and because of this the shoulder can be dislocated forward, backward, downward, partially, or completely. A very strong and precise amount of force is required to completely pusch the bones out of place. In addition, extreme shoulder rotation can dislocate the head of the humerus from the socket of the scapula. Sports injuries, car accidents, trauma, and hard falls can all result in a dislocated shoulder.
There are many immediate and easily noticeable symptoms that accompany a dislocated shoulder. Symptoms include:
- A visibly deformed shoulder
- An out of place shoulder
- Swelling
- Bruising
- Intense pain
- Inability to move the joint
- Numbness
- Tingling
- Weakness in the shoulder
- Spasms in shoulder muscles
Limiting movement, keeping the shoulder close to the body, applying ice, taking pain medication, and calling 911 are the best courses of action when dislocating a shoulder. One should not try to jam the head of the humerus back into the socket of the scapula, as this can cause further damage in the blood vessels, muscles, tendons, and ligaments of the shoulder.
It is relatively simple to diagnose a dislocated shoulder solely based on the physical deformity of the injury alone. During the physical exam, the physician will inspect the affected area for tenderness, swelling, and deformity. XRays are commonly taken to depict where the dislocation has moved the bones and the severity of the injury. MRIs and CT (CAT) scans are often done to eliminate the possibilities of other injuries.
Immediate care and certain medical procedures are highly recommended following a shoulder dislocation. A procedure known as “Closed Reduction” is common following a shoulder dislocation diagnosis. During this procedure, the doctor will carefully place the humerus back in the socket of the scapula into the correct alignment. Closed procedures do not require surgery. However, some surgical procedures may be required if muscles, tendons, or ligaments were affected during the injury.
After any procedure, a period of rest and immobilization using a splint or sling is typically necessary to keep the shoulder from moving and causing aggravation. Doctors often prescribe pain medication after procedures regarding a shoulder dislocation. After the splint or sling is removed, individuals are encouraged to undergo rehabilitation and physical therapy in order to increase range of motion and strengthen the muscles of the shoulder.
If you or a loved one are currently experiencing any symptoms of a shoulder dislocation, or have been diagnosed and require treatment, reach out to the experts at the Center for Orthopaedic Specialists. Contact us today!
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