Shoulder dislocations are one of the most common traumatic sporting injuries. The majority of shoulder dislocations occur anteriorly (bone comes forward from the joint socket). Shoulder dislocations can also cause damage to the labrum (cartilage) of the shoulder, fracture of the humeral head or glenoid (socket) and sometimes axillary nerve damage.
Patients typically report falling onto an outstretched arm with some force and describe feeling the shoulder popping out. Some individuals with increased ligamentous laxity are more prone to dislocations under less traumatic conditions. There will be an obvious deformity of the shoulder with a loss of the normal smooth contour of the shoulder. The humeral head is visible below a hollow under the top of the shoulder.
It is important to get the shoulder reduced as soon as possible, as it becomes more difficult to perform after a prolonged period of time. Ideally, the shoulder is x-rayed before the reduction is performed to rule out any fracture to the scapula or humerus. After this, patients are normally required to wear a sling and follow the RICE (rest, ice, compression, elevation) treatment protocol.
Depending on pain levels and the severity of injury, range of motion exercises are commenced as soon as able, avoiding combined external rotation/abduction. Strengthening of stabilising muscles of the shoulder is important in order to limit the risk of recurring shoulder dislocations. However, if a shoulder dislocation occurs in a young athlete, it is often advised that stabilisation surgery is performed, especially if he/she is hoping to return to playing contact sports.
Posterior dislocation occurs less commonly either from direct trauma or a fall on an outstretched arm that is rotated inwards.
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