Background
The shoulder is one of the most movable joints in the human body which that has the ability achieve a great range of motion. But it is important to emphasize that its capacity to move freely in all three planes makes it an unstable joint with an increased risk to injuries.
Recall that that the head of the humerus, the upper arm, is articulated to a shallow cavity located in the shoulder blade, making it vulnerable to injuries. A group of connective tissues surround the shoulder joints to stabilize the connection.
A dislocated shoulder is a common shoulder injury that usually occurs after a fall. In this condition, the head of the humerus is forced out of the shallow cavity after applying a force or load against the shoulder joint that is too great or excessive to what the connective tissues can normally withstand.
It is estimated that at least 95% of shoulder dislocations are anterior, meaning, the head of the humerus moves into the front of the shoulder. It affects more males than females as it is commonly attributed to contact sports.
In men, its occurrence peaks between 20 to 30 years. Shoulder dislocation in women is usually common between 61 to 80 years resulting from falls.
Causes
Shoulder dislocation could result from a strong force applied against the shoulder joint. An injury from a contact sport, a fall on an outstretched arm or a hard blow can pull the shoulder bones out of their normal positions.
Additionally, extreme rotation of upper arm can move the head of the humerus out of the cavity, giving rise to shoulder dislocation.
The usual injury mechanism of shoulder dislocation involves a combination of arm side elevation and excessive outer rotation of the humerus.
Signs and Symptoms
An acute, severe pain in the shoulder is usually felt at the time of injury. The pain could get so intense that the injured individual immediately discontinues the activity.
In addition, a deformity in the affected shoulder is visibly seen with signs of swelling and bruising. Because of the pain, the injured is not able to move the shoulder joint. At times, the pain could radiate down to the arm. Tingling sensations, weakness or numbness and muscles spasms in the affected arm and neck are also reported.
Diagnosis
It is advised to immediately consult a physician once a dislocated shoulder is suspected. A physical examination is done and a detailed medical history is obtained to come up with an accurate diagnosis.
The physician might order an X-ray, magnetic resonance imaging or MRI and electromyography to determine and examine the damaged structures.
Treatment
After the injury, as you wait for medical attention, it is advised to prevent any type of joint movement. A splint or a sling is used to temporarily immobilize the affected shoulder. An ice application on the injured area can reduce the pain and swelling.
The physician, in an appropriate setting, would put the dislocated shoulder bones back into their normal positions. Close reduction techniques, where gentle manual maneuvers are applied, are usually done by an experienced physician after the administration of a muscle relaxant or a sedative.
The intensity or severity of pain is usually immediately felt once the dislocated bones are back into place.
After shoulder relocation, the physician immobilizes the affected shoulder through a splint for several weeks to allow the swelling and inflammation to subside, encourage healing and to avoid aggravating the injury.
Strenuous activities involving the injured shoulder are avoided until the injured shoulder has fully regained its normal condition. Pain relievers or muscle relaxants are prescribed to reduce inflammation, swelling and pain.
After the splint is removed, a rehabilitation program is usually prescribed. The exercise regimen would normally include strengthening and flexibility exercises of the shoulder joint. Bear in mind that a dislocated shoulder is more vulnerable to have another episode of dislocation. These exercises are recommended to decrease the risk of its recurrence. A protective gear is encouraged if you are into contact sports.
In cases where the dislocated shoulder bones are not positioned back through close reduction techniques, a surgical manipulation or an open reduction is necessary. If the nerves and blood vessels are damaged, surgery is strongly indicated.
