Did you suddenly fall while playing? Or did you slip in the bathroom and hurt your shoulder? Suddenly, you could not even move your arm due to unbearable pain? Sometimes you may notice that the shape of your shoulder has changed. If something like this happens, it may be your dislocated shoulder. Although this is a bit scary, it is a condition that can be completely cured with the right treatment. So let's find out more about this.
What does this shoulder shrug mean?
Simply put, a dislocated shoulder means that the bones in your shoulder joint move back and forth from where they should be, separating from each other.
Let's explain this a little more. A joint in our body is where two bones meet. Your shoulder joint is made up of the ball of your upper arm (the humerus) and the socket or glenoid of your shoulder blade (the scapula). It's like a ball fitting into a socket. We call this a ``ball-and-socket joint''. This is the joint that allows us to move our arm in all directions.
A dislocated shoulder is when the ball-like bone completely pops out of the socket. When this happens, the delicate tissues around the joint can also be damaged.
That means:
- Muscles
- Nerves
- Tendons
- Ligaments
- Blood vessels
This is a very painful condition. If you feel like your shoulder is dislocated or you can't move your arm, never try to fix it yourself. The best thing to do is to go to the nearest hospital's Emergency Department (ETU) as soon as possible.
Are there different types of shoulder shrugs?
Yes, doctors classify this into two main ways. One is based on how far the bones are displaced.
1. Complete Dislocation or Luxation: This is when the two bones in the shoulder joint are completely separated from each other and come out. This is what we usually refer to when we say "dislocated shoulder."
2. Subluxation: This is when the bones do not separate completely, but rather move slightly, moving in half. The bones still touch each other, but not in the normal way. Although there is pain, it may not be as severe as a complete dislocation.
What are the symptoms of a dislocated shoulder?
A dislocated shoulder usually causes one or more of these symptoms.
| Symptom | Description |
|---|---|
| Severe pain | A sudden, unbearable, sharp pain. |
| Inability to shake hands | I can't lift my arm or rotate it. It feels like my arm is lifeless. |
| Change in shoulder shape | From the outside, the shoulder may appear sunken or protruding, as if it is not where it should be. |
| Swelling and bruising | The shoulder area is swollen and starting to turn blue/purple. |
| Muscle Spasms | As the body tries to protect itself from injury, the muscles around the shoulder begin to tighten, which increases the pain. |
| Tingling or weakness | You may feel a tingling or numbness in your hands, palms, or fingers if those nerves are affected. |
Why does a shoulder jump? Who is at risk?
This can happen if there is enough force applied to the shoulder joint to cause it to pop out. It is usually caused by things like:
- Falls: Things like falling from a height, slipping, etc.
- Car accidents: Impact on the shoulder in a car accident.
- Sports accidents: Shoulder injuries can occur, especially in contact sports like rugby and football, and while diving in cricket or playing volleyball.
Who is most at risk?
Although anyone can get a shoulder dislocation, some people are at greater risk.
- Players: Especially those who play games that involve hitting each other.
- Men: Men are more than twice as likely to have a shoulder dislocation than women.
- Young people between the ages of 15-30: People in this age group are more likely to have accidents because they are active.
- People who have dislocated their shoulder before: Once you dislocate your shoulder, the ligaments around that joint become a little weaker. Therefore, the chance of dislocating it again is much higher.
What are the possible complications of a dislocated shoulder?
A shoulder dislocation is not just a bone moving back and forth. The impact can also damage the tissues surrounding the shoulder.
- Bone fractures: Small pieces of bone can break off when the shoulder is dislocated.
- Ligament and tendon sprains: These tissues that hold the joint together can be stretched or torn.
- Nerve damage: The nerves that run around the shoulder can be pinched or compressed.
- Damaged blood vessels: Although rare, blood vessels can be damaged.
Some people develop a condition called a Hill-Sachs lesion when they dislocate their shoulder. This is when the ball of the humerus (the ball-like bone in the upper arm) becomes damaged. This type of damage can occur when the shoulder dislocates and the ball-like bone hits the socket.
How does a doctor diagnose and treat this?
When you go to the ETU, the first thing the doctor does is examine your shoulder. He asks you how it happened and what symptoms you are experiencing now.
After that, tests like these may be done to check for internal damage:
- X-rays: This is essential to see if the bone is dislocated or broken.
- MRI scan (Magnetic resonance imaging): This helps to detect damage to delicate tissues such as ligaments and tendons.
- CT scan (Computed tomography scan): This is done to get a clearer picture of the damage to the bones.
Treatment methods
The most important and first treatment for a dislocated shoulder is to put the dislocated bone back in place.
This is called a 'closed reduction' . This is not surgery. The doctor will hold your body from the outside and gently pull your shoulder back into place. During this procedure, you may be given a local anesthetic injection into your shoulder to reduce pain or sedatives to make you feel a little sleepy.
Extremely important:
- Don't try to fix your shoulder on your own.
- Don't let anyone who isn't a doctor touch or fix your shoulder.
Doing so can cause severe damage to nerves, blood vessels, and other tissues, making the condition even worse.
After realigning the shoulder, the doctor will recommend the following treatments:
- Immobilization: After the shoulder is in the correct position, a sling or splint is placed to immobilize the arm. This is to give the shoulder a rest and allow the damaged tissue to heal. The arm is usually kept in this position for several weeks.
- Medication: The doctor will prescribe painkillers to reduce pain and swelling.
- Rest: You should avoid doing anything that puts a strain on your shoulders or makes you feel tired.
- Physical therapy: This is very important. Once your shoulder starts to heal, you should start exercising under the guidance of a physical therapist. You will first start with simple exercises to reduce the stiffness in your shoulder, then move on to exercises to strengthen the muscles around your shoulder. If you don't do this properly, you are more likely to have a recurrence of your shoulder sprain.
Will surgery be necessary?
Most of the time, a dislocated shoulder does not require surgery. However, surgery may be necessary in the following cases:
- If the ligaments and tendons of the shoulder are severely damaged during a fall.
- If the 'closed reduction' method cannot put the shoulder back in the right place.
- If your shoulder pops frequently, it's because the ligaments are too weak. Surgery can be done to tighten those ligaments.
How long will it take to heal?
A dislocated shoulder takes several months to fully heal. The arm needs to be immobilized for the first few weeks. After that, you will need to do physical therapy for several months.
If you are an athlete, you should definitely consult your doctor before starting to play again. If you do heavy work or play before your shoulder has fully healed, there is a high chance that you will dislocate your shoulder again and worsen the injury.
Most people make a full recovery with proper treatment and physical therapy. They can return to their normal activities and sports.
Take-Home Message
- A dislocated shoulder is when the bone in the shoulder joint pops out of place. This is a very painful experience.
- If you suspect you have a dislocated shoulder, never try to fix it yourself or have someone else do it.
- Go to the nearest hospital emergency room (ETU) immediately. Keep the arm as still as possible.
- After a doctor puts the shoulder back into place (closed reduction), it is essential to keep the arm still and undergo physical therapy.
- It is very important to do physical therapy exercises correctly to prevent re-sprains and strengthen the muscles.
- Until you are fully healed, follow your doctor's instructions and avoid activities that put strain on your shoulder.
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