The shoulder is an unstable, mobile joint that can turn in many directions, which makes it particularly susceptible to dislocation. If you have a dislocated shoulder, you should immediately seek medical attention to have it put back into place before getting any additional long-term treatment.
What is a dislocated shoulder?
A dislocated shoulder occurs when the upper arm bone (humerus) pops out of the shoulder socket (glenoid). A complete dislocation is when the humerus is all the way out of the glenoid. In a partial dislocation, known as subluxation, it is only partially out of the socket. Partial and complete dislocations cause instability and pain in the shoulder.
Dislocated shoulder symptoms
Shoulder dislocation can cause severe shoulder pain. Other symptoms include:
- Swelling or bruising
- A hard knob under the skin, near the shoulder and at the top of the humerus, that has popped out of its socket
- Inability to move the joint
- A visibly out-of-place, deformed shoulder
- Numbness, weakness, or tingling in the neck or down the arm
- Muscle spasms in the shoulder
Types of shoulder dislocation
Shoulder dislocation is classified depending on the direction of the dislocation:
- Anterior dislocation: The most common form of shoulder dislocation is an anterior dislocation. In this form of dislocation, which occurs in 95% of cases, the humerus is displaced forward toward the front of the body. Anterior dislocation in young people often happens during sports. In older people, it is typically caused by falling on an outstretched arm.
- Posterior dislocation: Posterior dislocations occur when the humerus is displaced toward the back of the body. They account for 2-4% of all shoulder dislocations, and typically occur due to seizures, electric shock, or a fall on an outstretched arm.
- Inferior dislocation: The rarest form of shoulder dislocation, an inferior dislocation, occurs when the top of the humerus is displaced downward. It occurs when the arm is pushed downward due to trauma.
What causes shoulder dislocation?
The shoulder is the most commonly dislocated joint in the body, since it moves in multiple directions and the tissue that joins the bones of the shoulder can be stretched or torn. Shoulder dislocation is typically caused by a strong force or extreme rotation.
Common causes of shoulder dislocation include:
- Sports: Shoulder dislocation is a common injury in sports that involve falls, like gymnastics, skiing and volleyball, or contact sports, like hockey and football.
- Non-sports related trauma: An everyday blow to the shoulder, such as in a car accident, is another common cause of shoulder dislocation.
- Falls: Falling onto the shoulder from a ladder or tripping on a loose rug can cause dislocation.
- Loose ligaments: Shoulder dislocation is usually due to some form of trauma, but it can occur from seemingly harmless motions, such as raising an arm. In these cases, the real cause could be loose ligaments in the shoulder, which can increase a person’s risk of joint dislocation.
How is a dislocated shoulder diagnosed?
Your doctor will complete a physical exam and ask you about the nature of the injury, how long the shoulder has been hurting, what other symptoms you’ve experienced, and if you’ve experienced this before. Knowing how you dislocated your shoulder, as well as what form of dislocation it is — anterior, posterior, or inferior, will help your doctor treat your symptoms.
Your doctor may also order an X-ray to examine your shoulder in more detail, making sure that you don’t have any additional injuries, such as broken bones.
What happens to a dislocated shoulder if it’s left untreated?
“For shoulder dislocation, if it’s untreated, it will continue to dislocate,” says Dr. Vladimir Alexander, Founding Partner of Alexander Orthopaedics. “You’ll have an unstable shoulder, you’ll wear out the ball-and-socket cartilage, and then you’re gonna need a shoulder replacement. So, don’t ignore it — get it treated.”
Complications of shoulder dislocation
Complications of a dislocated shoulder include:
- Shoulder instability, which makes you prone to re-injury, especially in cases of severe or repeated dislocation.
- Tearing of tendons, ligaments, or muscles that reinforce the shoulder joint, such as a shoulder labral tear.
- Nerve or blood vessel damage around the shoulder joint — peripheral nerve injuries are common following anterior dislocation.
If you dislocate your shoulder, you should seek immediate medical attention, and have the joint put back into place at the hospital with a process called a closed reduction. Intense pain stops almost immediately once the shoulder is reduced. However, after the reduction, the shoulder needs definitive treatment. One week or so after your shoulder joint has been put back into place, you should see an experienced orthopedic specialist.
What is the treatment for a dislocated shoulder?
Nonsurgical treatment
Conservative treatments are often the first applied unless research shows that treatment will not be successful for that particular injury. For example, a young patient who has a dislocated shoulder and labral tear would most likely require surgery. However, in other cases, the following nonsurgical treatments would first be applied:
- Rest and ice: Lots of rest is needed to help with recovery, along with ice that is applied three to four times a day to help reduce pain and swelling.
- Pain medication: Ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn) or acetaminophen (Tylenol) can help you manage the pain.
- Bracing: After the shoulder joint is put back into its normal position, your arm may need to be in a sling for a few weeks. A brace can help if the shoulder still needs stability.
- Physical therapy: Once the pain and swelling has decreased, physical therapy and rehabilitation can help restore motion and strength to the shoulder. The type and duration of physical therapy will depend on the severity and nature of your injury.
- Activity modification: Until you’re cleared by a doctor, you should not participate in sports or other strenuous activities to prevent any further damage to the shoulder.
Surgical treatment
Surgery may be required for a dislocated shoulder if you continue to experience severe pain or if your injured shoulder remains unstable and loose despite physical therapy and bracing. Arthroscopic shoulder surgery may also be implemented to repair torn or stretched ligaments.
Younger, more active patients may be more likely to have surgery since the younger and more active you are, the higher the risk you have for re-dislocation. According to a systematic review published in Arthroscopy: The Journal of Arthroscopic & Related Surgery, surgical treatment was associated with a significantly lower rate of recurrent instability in the short- and long-term for younger patients that had experienced a traumatic anterior shoulder dislocation. Treatment must be “tailored to each individual’s age, occupation and degree of physical activity,” as stated in The Archives of Bone and Joint Surgery.
Dislocated shoulder recovery
While your ability to move your shoulder will immediately improve upon setting the humerus back into place, full range of motion requires six to eight weeks to restore. In addition, most shoulder strength will return within three months, but it may take up to a whole year to regain full strength.
If you have dislocated a shoulder, it’s critical to get definitive treatment to establish full range of motion and stability in your shoulder. Our orthopedic surgeons and physical therapists are experts in shoulder treatment and surgery, and will work with you one-on-one to create a treatment plan that will build strength, motion and stability in your shoulder.