What is a dislocated shoulder (or shoulder instability)?
The shoulder joint is the body's most mobile joint. It can turn in many directions, but this advantage also makes the shoulder an easy joint to dislocate.
A partial dislocation (subluxation) means the head of the upper arm bone (humerus) is partially out of the socket (glenoid). A complete dislocation means it is all the way out of the socket. Both partial and complete dislocations cause pain and unsteadiness in the shoulder.
- Deformity
- Swelling
- Numbness
- Weakness
- Bruising
Sometimes a dislocation may tear ligaments or tendons in the shoulder or damage nerves.
The shoulder joint can dislocate forward, backward, or downward. A common type of shoulder dislocation is when the shoulder slips forward (anterior instability). This means the upper arm bone moved forward and out of its socket. It may happen when the arm is put in a throwing position.
The muscles may have spasms from the dislocation, and this can make it hurt more. When the shoulder dislocates time and again, there is recurrent shoulder instability.
Do I need surgery?
Initial management includes reducing the shoulder joint, otherwise known as putting it "back in place." Sometimes this can be done in the Emergency Department, but on occasion requires reduction in the operating room. A post-reduction X-ray and MRI will be ordered to understand the extent of soft tissue or bony damage to the shoulder joint. You may need to immobilize the shoulder in a sling for a few to several weeks depending on the imaging findings.
Non operative vs surgical care is determined by: imaging findings, age, activity level, overall health, frequency/history of dislocations, among other factors.
Non surgical management focuses on physical therapy to strengthen the muscles around the shoulder girdle after a period of immobilization. If shoulder dislocation becomes a recurrent problem or if therapy fails to improve symptoms, surgery may be needed to repair or tighten the torn or stretched ligaments that help hold the joint in place, particularly in young athletes.
At times, the recurrently dislocating shoulder can result in some bone damage to the humerus or shoulder socket. If your surgeon identifies some bone damage, bone grafting may be necessary.
To request a consult with Dr. Logan, please call: 720-726-7995.
