Shoulder Dislocation: Causes, Treatment & Recovery

What is shoulder dislocation?

A shoulder dislocation happens when the ball-shaped head of the upper arm bone (humerus) in your shoulder pops out from its socket. As a result, the surrounding tissues of your shoulder joint may become injured.

Because the shoulder joint facilitates shoulder mobility, such as rotation or lifting, injuries to this joint can significantly hinder daily activities. Additionally, severe pain, swelling, and restricted range of motion may accompany the injury.

Causes of shoulder dislocation

Traumatic injuries, particularly those sustained during contact sports or accidents, are the most common cause of shoulder dislocations. 

Common causes of shoulder dislocations are:

• Injuries: 

  • Sudden and forceful impacts during physical activities, such as rugby or wrestling, can cause the shoulder to dislocate.

• Falls: 

  • Falling with an outstretched hand or getting hit on the shoulder can cause shoulder dislocation. This is common in activities such as cycling, hiking, or exercising on uneven surfaces.

• Traffic accidents: 

  • Being involved in a traffic accident can result in shoulder dislocation. 

• Repetitive activities: 

  • Repetitive shoulder movement, such as swinging and carrying heavy loads above your head, can weaken the shoulder joint over time, making it more susceptible to dislocation.

• Previous dislocation: 

  • Once a shoulder has dislocated, the joint and its supporting structures (ligaments, tendons, and muscles) may become weaker or damaged, making recurrent dislocations more likely.

Types of shoulder dislocation

The shoulder joint is the most flexible joint in the body, allowing for a wide range of movement. However, this flexibility also makes it prone to dislocation when subjected to a strong external force. 

A shoulder can dislocate in three main directions: forward (anterior), backward (posterior), or downward (inferior), and these dislocations can be either complete or partial.

• Anterior dislocation: 

  • This is the most common shoulder dislocation and occurs when the humeral head moves forward out of its socket, often due to a fall or a blow while the arm is raised.

• Posterior dislocation: 

  • Posterior shoulder dislocations are less common than anterior dislocation and happen when the humerus shifts backward. An impact to the anterior shoulder or violent muscle contractions (seizures or electrocution) can cause this dislocation.

• Inferior dislocation: 

  • This is a rare condition where the humeral head moves downward from its shoulder socket. This usually results from severe trauma and may lead to neurovascular damage.

Symptoms of shoulder dislocation

A ligament tear can have different symptoms depending on the severity of the injury and the location of the injury. 

Here are the common symptoms of a ligament tear, such as:

• Severe pain, particularly when attempting to move the shoulder.

• Visible deformity where the shoulder appears visibly out of place.

• Swelling or bruising around the joint.

• Limited range of motion on the arm or shoulder.

• Numbness or tingling, which may indicate nerve damage.

If you are experiencing the symptoms listed above and suspect you have a dislocated shoulder, don’t hesitate to request an appointment with our specialists at Thomson Medical for an accurate diagnosis and a personalised treatment plan.

Diagnosis of shoulder dislocation

To diagnose shoulder dislocation, your doctor will first talk to you about how the injury happened and the symptoms you're experiencing. They may then examine your medical history to see if there have been any previous shoulder injuries or dislocations.

Physical examination

After the initial examination, the doctor could conduct a physical examination of the joint to evaluate the extent of the injury, its stability, and range of motion. A common physical examination a doctor could do, such as: 

• Looking for visible deformity: 

  • In an anterior shoulder dislocation, the shoulder may seem squared or flattened. The arm may be positioned awkwardly with a minor outward rotation.

• Palpation: 

  • The doctor may feel the shoulder joint to assess if the humeral head has moved out of its socket.

• Mobility tests: 

  • The doctor will evaluate your range of motion to see if moving the shoulder causes significant pain. It’s common for patients to experience extreme discomfort and limited movement in the affected shoulder.

• Neurovascular exam: 

  • The doctor will check the affected arm or hand for numbness, tingling, or weakness to see whether there is damage to nerves or blood vessel.

Imaging tests

To get a better diagnosis, your healthcare provider may perform imaging tests such as X-rays, magnetic resonance imaging (MRI) scans, and CT (Computed Tomography) scans. 

This test aims to verify the dislocation and evaluate if the shoulder dislocation causes any harm to the shoulder bones and surrounding tissues.

Neurological and vascular testing

If there is concern about nerve or blood vessel damage, the healthcare provider may conduct additional tests, including:

• Nerve conduction studies and electromyography (EMG): 

  • These tests assess the function of the nerves in the shoulder and arm, especially if there is numbness, weakness, or muscle dysfunction.

• Vascular exam: 

  • A doctor may check for compromised blood flow in the arm, as shoulder dislocation can sometimes damage nearby blood vessels.

How are shoulder dislocations treated?

Shoulder dislocation is a serious injury that requires immediate medical treatment. Delaying treatment can increase the risk of complications. 

Typically, treatment includes the following steps:

• Reduction: 

  • A healthcare professional will gently reposition the humeral head back into its socket through a procedure known as reduction. 

• Immobilisation: 

  • After the reduction procedure, the shoulder is immobilised with a sling or brace for several weeks to allow the ligaments and soft tissues to heal. The duration of immobilisation depends on the severity of the dislocation.

• Pain management: 

  • To manage pain and reduce inflammation, doctors may recommend over-the-counter pain relievers like ibuprofen or paracetamol.

• Physiotherapy: 

  • Once the initial swelling and pain subside, physical therapy may be recommended to strengthen the muscles around the injured shoulder joint to restore mobility and function.

  • Physical therapy aims to strengthen the rotator cuff muscles and stabilise the shoulder joint to prevent recurring injuries and restore full range of motions.

• Surgery: 

  • In cases of complete dislocation of the shoulder joint or severe damage to the ligaments or bones, surgery may be required to repair or tighten the soft tissues around the joint. 

  • Arthroscopic surgery is a common approach, allowing for minimally invasive repairs.

A dislocated shoulder requires immediate medical attention from trained healthcare professionals. Never attempt to push or manipulate the shoulder back into place yourself, as this can cause complications. 

If you suspect a shoulder dislocation, minimise all movement of the injured arm by keeping it still and close to your body, using your other hand or clothing to support it if needed.

Even if well-meaning friends or family offer to help, decline any attempts to manipulate the shoulder—only allow licensed medical professionals to treat the injury. The proper treatment in a medical setting will include appropriate pain management and techniques to safely return the shoulder to its correct position.

How to prevent shoulder dislocation?

Shoulder dislocation is not entirely preventable, especially if it resulted from an activity or accident you cannot avoid. Here are some steps you can take to lower your risk of shoulder dislocation, including:

• Strengthen shoulder muscles: 

  • Increasing the strength of the shoulder muscles, particularly the rotator cuff, enables it to absorb more force and reduces the risk of injury.

• Warm up: 

  • Before engaging in any physical activity, warming up and stretching the shoulder muscles can reduce the risk of shoulder dislocation.

• Protective gear: 

  • In contact sports, wearing appropriate protective gear, such as shoulder pads, can provide extra support to the shoulder joint and help absorb impacts.

• Proper technique: 

  • Whether in sports or everyday activities, using the correct technique when lifting, throwing, or reaching high places can reduce strain on the shoulder joint.

• Avoid repetitive overhead movements: 

  • Individuals prone to shoulder injuries should be mindful of repetitive overhead movements that can place stress on the shoulder joint.

Complications of shoulder dislocation

Shoulder dislocation is a serious injury that can lead to several complications if not immediately and properly treated. Here are some common complications associated with shoulder dislocation:

Recurring dislocations

The supporting ligaments and muscles of the shoulder joint may weaken or stretch after the initial dislocation, increasing the risk of another dislocation.

Nerve and blood vessel damage

Dislocation of the shoulder can stretch or compress nearby nerves and blood vessels, causing damage.

Rotator cuff tears

A dislocated shoulder may result in a torn rotator cuff, which would impair arm movement, causing chronic pain. A surgical procedure might be necessary to restore full function of the shoulder.

Chronic shoulder instability

Recurring dislocations and damage to the shoulder's supporting structures can lead to chronic shoulder instability. This condition means the shoulder joint is prone to slipping out of place with minimal strain on the shoulder.

Arthritis

Over time, repeated shoulder dislocations or untreated injuries can lead to arthritis. This condition occurs when the cartilage in the shoulder joint deteriorates, resulting in chronic pain, stiffness, and a reduced range of motion.

Labral tears (bankart lesion)

A Bankart lesion occurs when the labrum, a ring of cartilage that deepens the shoulder socket, is torn during a shoulder dislocation.

This injury compromises the stability of the shoulder joint and increases the likelihood of future dislocations. In some cases, surgical intervention may be necessary to restore stability to the joint.

Hill-sachs lesion

A Hill-Sachs lesion is a compression fracture of the humeral head (the ball of the shoulder joint) that occurs when it collides with the edge of the shoulder socket during dislocation. 

This injury can impact the stability of the joint, potentially leading to long-term complications such as arthritis and causing recurring dislocations.

FAQ

How do you fix a dislocated shoulder?

Here are some options to treat dislocated shoulders, such as:

• Reduction

• Immobilisation

• Pain management

• Physiotherapy

• Surgery

How long is the recovery for a dislocated shoulder?

Dislocated shoulders might heal in 12 weeks and take 16 weeks to resume sports or exercise. However, depending on the severity of the injuries, recovery times may vary and be either faster or longer.

Can you move your arm if your shoulder is dislocated?

Following a shoulder dislocation, your ability to move your arm may vary depending on the type and severity of the dislocation. In some cases, you might find that you can move your arm slightly, but this often comes with discomfort or pain. 

However, a complete shoulder dislocation typically severely restricts movement, and attempting to do so can cause significant pain.

Can a dislocated shoulder heal by itself?

No, if a shoulder dislocation is not treated properly right away, it can result in complications. Appropriate and prompt treatment reduces the risk of complications and promotes full recovery.

Can you fix a dislocated shoulder by yourself?

A dislocated shoulder should never be fixed by yourself. Only trained healthcare professionals should treat this injury. Attempting to push the shoulder back into place on your own can cause further injury to the affected shoulder.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please consult a specialist at Thomson Medical. Book an appointment with Thomson Medical today.