Shoulder Dislocations
By Brian M. Torpey, MD, FACS

Shoulder dislocations are commonly the result of a violent injury to the shoulder that causes the ball of the upper arm bone (humerus) to be pulled away from the shoulder socket bone (glenoid). The shoulder joint is the body’s most mobile joint, which allows the arm to be moved in different directions, but unfortunately this places the shoulder at risk for injury when certain forces are applied.

Although the shoulder joint can dislocate forward, backward or downward, the most common type of shoulder dislocation is a forward separation. This injures the bones of the shoulder and the soft tissues that support and protect the shoulder capsule.

At the time of the shoulder dislocation, fractures of both the ball and the socket can occur up to 30% of the time. These associated fractures, as well as injuries to the lip that supports the socket and the rotator cuff muscles that support the ball component of the shoulder, are injuries that commonly occur as a result of shoulder dislocation.

Shoulder dislocations are by definition a medical emergency and they require immediate attention to place the shoulder ball back into its socket. X-rays typically are required to evaluate the type of shoulder dislocation that has occurred and to confirm that the shoulder is put back into the socket in the proper manner. The patients typically experience significant pain and muscle spasm as a result of dislocation, and often times an emergency room visit is necessary in order to get the shoulder back into its socket in the appropriate manner.

After the shoulder socket has been relocated, then patients are typically treated in a sling for several weeks to allow the injured soft tissues to heal. Regular icing of the shoulder will help during this recovery period, as will pain and anti-inflammatory medications. Rehabilitation, to strengthen the shoulder muscles, is also commonly required after dislocation occurs.

Recurrent shoulder dislocations that do not respond to physical therapy and conservative care may require surgery to repair and/or tighten the injured soft tissues that support the shoulder capsule. These procedures are typically performed arthroscopically and they have been shown to allow athletes, as well as non-athletes, to return to their prior level of function without recurrent dislocations.

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