The shoulder is a complex ball-and-socketlike joint consisting of three main bones -the humerus (the upper part of the upper arm bone), the clavicle (the collarbone), and the scapula (or shoulder blade, the largest bone in the chest-shoulder region). The humerus forms the ball in the ball-and-socket -like joint and is attached by ligaments-connective tissue- to the scapula.
Bursas - fluid-filled sacs or saclike cavities- surround and cushion the bones and allow for movement. Muscles, including the trapezius, deltoid, pectorals, and latissimus dorsi, travel over, under, and around the shoulder joint and add stability. Tendons (also connective tissue) connect these muscles to bone.
What the Shoulder Does: The shoulder allows movement of the hand and arm in space.
What the Injury Is: A dislocated shoulder is a shoulder “out of joint.” It occurs when the humeral bone in the upper arm comes out of the joint and sticks out, usually on the front or top of the shoulder. In severe cases, ligaments, tendons, and other connective tissues are stretched and injure nerves and blood vessels in the shoulder region, sometimes causing numbness in the hand.
Cause: The injury can be caused by a traumatic event, as in a direct blow to or a fall on the shoulder, or by a fall on your outstretched hand or arm. Susceptibility to a dislocation may also be genetic, particularly if the shoulder “goes out” or “pops out” often or easily. Members of the same family may also be afflicted. In some cases, the shoulder can dislocate while the individual is sleeping. A shoulder dislocation is common in contact sports, especially football. Other sports that may cause the injury: downhill skiing, lacrosse, hockey, volleyball, rugby, and soccer.
Symptoms: Severe pain at the moment the injury occurs. Limited movement in the shoulder area. Swelling, bruising, and internal bleeding. The shoulder may look odd, with a large bump rising up under the skin.
Immediate Treatment: Use an ice pack to reduce swelling. Cold treatments help stop internal bleeding and the accumulation of fluids in and around the injured area, thus decreasing swelling.
Seek medical treatment at a physician’s office or hospital emergency room. (Individuals with recurring dislocations may be able to “pop” the shoulder back into place.) The shoulder may be put in a sling or wrapped to immobilize the area and aid recovery.
Medication: First, follow your physician’s advice. You may be given a pain-relieving drug, such as codeine with aspirin or acetaminophen. You may also be given a nonsteroidal anti-inliammatory drug (NSAID) to reduce pain and swelling.
WARNING: Do not give aspirin to children under the age of 16. If pregnant or nursing, consult with your physician first before taking any medication.
Continued Care: Avoid participation in sports until the shoulder has had time to heal. The healing process may take 3 to 6 weeks, depending upon the extent of the injury. With your physician’s okay, work with a trainer or physical therapist to strengthen muscles in the shoulder region.
Medication: First, follow the advice of your physician. Take aspirin, ibuprofen, or acetaminophen to help reduce pain and inflammation.
NOTE: Acetaminophen may not contain as much of the anti inflammatory agents as aspirin or ibuprofen. Ask your physician or pharmacist for guidance.
Long-Term Effects of Injury: With proper healing, a full range of motion should return. In some cases, surgery may be recommended to help stabilize the shoulder. The procedure may involve cutting stretched ligaments and tendons.
Prevention of Recurring Injury: Avoid situations in which another injury could occur. Wear layers of clothing or padding to help cushion any fall that may be likely. Use weights and exercises advised by a trainer or physical therapist to strengthen muscles in the shoulder region. Muscle-strengthening exercises also help strengthen ligaments and tendons. Use an ice pack to reduce any swelling, then a heating pad to aid recovery. (Heat treatments help to enlarge the small blood vessels in and around the injured area, thus increasing blood circulation.)
See Your Physician: The first time a dislocation occurs, for rehabilitation and treatment to prevent recurrence.