Don’t dislocate

by Dr. Chris Singh

In order to understand shoulder dislocations it is first necessary to review the anatomy and structure of the joint.

We all know that the shoulder joint looks like a ball and socket. The joint is held together and stabilized by numerous soft tissues such as ligaments, muscles and a joint capsule. It is safe to say that the shoulder is one of the most complex joints in the body. It is definitely the most mobile joint, however it sacrifices stability for mobility. As a result, the shoulder is the most frequently dislocated joint in the body.

A shoulder dislocation occurs when the arm bone or ball part of the joint pops out of the cup shaped socket. Due to the fact that the shoulder can move in several directions, it can dislocate forwards, backwards or downwards. The most common dislocation is forward and down. It usually requires a strong force or sudden blow to the shoulder area to cause the joint to dislocate. It is important to note that extreme rotation of the shoulder could also cause a dislocation.

Sports injuries in contact sports such as hockey and football are the most common causes of shoulder dislocations. However, trauma related to motor vehicle accidents or slips and falls are also common causes.

Males in their teens or early twenties are at higher risk of shoulder dislocations.  This is most likely due to the fact that this group tends to be physically active.

It is sometimes hard to tell if a shoulder is dislocated or is just badly sprained. The first sign of a shoulder dislocation is intense pain. Often, pain is accompanied by swelling and bruising of the shoulder and surrounding area.

It is common for the shoulder joint to be visibly deformed or to look out of place. In severe cases, the person suffering the dislocation will be unable to move the joint. Other symptoms include numbness, tingling or weakness in the surrounding area, including the neck and arm. Severe muscle spasms may also be present.

If you suspect a dislocated shoulder, do not move the joint or try and put it back into its socket. This can damage the surrounding muscles, ligaments, nerves or blood vessels. The best course of action is to immobilize the joint in a splint or sling and seek medical attention.

The are several forms of treatments for shoulder dislocations, depending of the individual case. The most common form of treatment is called closed reduction. This involves the doctor gently maneuvering the shoulder bones back into their proper positions.  Pain medications, muscle relaxants or mild sedatives may be required to perform this treatment. In rare cases, general anesthetic is required before shoulder manipulation. 

After the doctor has reduced the dislocation, they may recommend immobilization using special splints for up to three weeks. Pain and anti-inflammatory medication may also be prescribed.

Physical rehabilitation may be required once the splint has been removed. The goal of physical therapy would be to restore the movement of the shoulder and to strengthen and stabilize the joint.

The good news is that most individuals fully recover and regain shoulder function within a few weeks.

However, once you have dislocated your shoulder joint, you may be more susceptible to future dislocations.

As such, it is very important to follow the specific instructions from your doctor or physical therapist in order to minimize the chances of reoccurrence. In rare cases where multiple dislocations have occurred or there is damage to nerves or blood vessels, surgery may be required. Until next month, drive safely.

***

Dr. Christopher H. Singh runs Trans Canada Chiropractic at the 230 Truck Stop in Woodstock, Ont. He can be reached at 519-421-2024.


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