A shoulder dislocation or shoulder dislocation is the displacement of the bone parts in the shoulder joint. The bones may have slipped out of the joint only partially or completely. The dislocated shoulder needs to be treated as soon as possible.
What is a shoulder dislocation?
A dislocated shoulder (shoulder dislocation) is a displacement of the bones involved in the shoulder joint, so that the joint is disturbed in its usual mobility. The shoulder joint is one of the largest joints in the body and belongs to the ball and socket joints.
The spherical head of the upper arm bone lies in the very small joint socket on the shoulder blade. Since this bony connection does not provide sufficient stability, the shoulder joint is additionally held in place by a joint capsule, muscles, tendons and ligaments. In a shoulder dislocation, the head of the humerus dislocates partially or completely from the socket. See bestitude for Meanings of Hypoglycemia.
It can also tear ligaments, damage muscles, and crush nerves and blood vessels. A distinction is made between traumatic shoulder dislocation, which occurs as a result of external violence, and atraumatic shoulder dislocation, in which the joint bones shift even with simple movements due to slack ligaments.
Causes
In a traumatic shoulder dislocation, an external force applied to the joint causes the dislocation. This often happens in ball sports, for example when two field players collide their shoulders or when the athlete falls and falls on his shoulder.
A dislocated shoulder can also occur in sports such as judo, in which twisting and pulling movements of the arm occur. After an initial dislocation, further dislocations can occur if the holding apparatus has already worn out due to the first displacement or the dislocation was not able to heal properly. This is referred to as a habitual (habitual) dislocation of the shoulder. It can be triggered by shaking hands vigorously.
An atraumatic shoulder dislocation is usually triggered by congenital causes. This can be a congenital laxity of the ligaments or a misalignment of the joint socket (acetabular dysplasia). Various genetic diseases, such as Down’s syndrome, have as an accompanying symptom a very elastic, rubbery capsule tissue around the joints. This makes them unstable and a shoulder dislocation can happen without any force in normal, simple movements.
Symptoms, Ailments & Signs
A dislocated shoulder can result from an unfamiliar movement or strain. This clinical picture is of course characterized by typical symptoms and signs that affected people often perceive very painfully. A very clear symptom of a dislocated shoulder is a long-lasting feeling of stiffness.
Even with the smallest movements, the affected person perceives severe pain. Therefore, there is a significant restriction in everyday life. In many cases, the affected area becomes very warm because muscles and tendons are inflamed. Due to the dislocated shoulder, many affected people assume a relieving posture, which leads to tension.
If you leave such a dislocated shoulder completely without medical care, you must expect the existing symptoms to worsen significantly. The pain increases, so that it can occur even at rest. The relieving posture just described can lead to inflammation in the joints. Under certain circumstances, there is even a risk of permanent consequential damage, so that a visit to the doctor is essential.
A dislocated shoulder is characterized by fairly clear and typical symptoms, so that affected people can diagnose a dislocated shoulder themselves. Anyone who does without appropriate treatment at this point must expect a significant worsening of the individual symptoms. Otherwise, a timely and full recovery cannot be guaranteed.
Diagnosis & History
A dislocated shoulder causes severe pain immediately . The arm can no longer be moved, partly because of the pain and partly because the joint has lost its ability to function. If nerves are also squeezed as a result of the dislocated shoulder, numbness can occur.
Blood vessels can also be pinched off by the displaced bones, which leads to circulatory disorders. A trip to the doctor is unavoidable because the patient himself can no longer push the bone back into the normal position. Due to the changed contour of the joint, the doctor will already recognize that a dislocated shoulder is present. A physical examination and testing of mobility are usually not possible, as this would lead to severe pain.
Usually the patient’s arm muscles are very tight to keep the arm in the existing position and to avoid any painful movement. With an x-ray, the doctor can clearly see the shoulder dislocation and also see if there are any bony injuries.
Complications
A dislocated shoulder is often accompanied by swelling or bruising, which can become infected if poor hygiene is maintained. As a result of the restricted mobility of the joint, those affected often hold their arm in a relieving position – malpositions and joint wear can be the result. Losses and other sensory problems in the lateral shoulder can occur if there is a concomitant nerve injury.
Arterial injuries are accompanied by reduced blood flow in the affected areas, causing symptoms of paralysis. The often accompanying ruptured tendon in the shoulder can weaken the flexion of the forearm, which can lead to further pain and restricted movement, which in some cases can become chronic. A shoulder dislocation can also be associated with the so-called Bankart lesion, in which the joint lip partially tears off.
This can result in a chronic dislocation of the shoulder. The surgical treatment of a dislocated shoulder also involves risks. Nerve injuries or inflammation can occur. Prescribed painkillers may cause side effects or interactions. Will be back with that too soonSportsstarted, the shoulder can dislocate again as a result and must then be treated again.
When should you go to the doctor?
If a persistent shoulder dislocation occurs, the affected person should consult a doctor. A dislocated shoulder can have unsightly long-term consequences without professional clarification. In addition, the pain is usually difficult to bear.
In order to avoid long-term effects, the treatment and clarification of the dislocation should be carried out by a specialist. The best contact person is the orthopedist.
Treatment & Therapy
A dislocated shoulder must be put back into place as quickly as possible. It must be ensured that no surrounding structures are injured during the reduction.
Since this treatment only causes severe pain for a short time, the patient is usually lightly sedated and given painkillers for a reduction . In some cases, a brief general anesthetic is also used. After setting, it is checked whether all the surrounding ligaments, tendons, muscles, nerves and vessels are functional and undamaged. After that, the arm must be immobilized for a while. To support the healing of affected tissue, decongestant, anti-inflammatory and pain-relieving drugs are usually administered.
If surrounding structures have been injured by the dislocated shoulder, an operation is necessary. Torn ligaments and tendons are sewn up, splintered bones are removed or, if possible, reassembled. Finally, after a successfully treated shoulder dislocation, physiotherapy exercises are necessary to restore the full functionality of the joint.
Prevention
You can only prevent a dislocated shoulder to a limited extent. If you already know that you have slack ligaments, or if you have already had a dislocated shoulder, ball and contact sports in particular should not be practiced. Overall, activities that place a particular strain on the shoulder should be avoided.
Aftercare
The aftercare of a dislocated shoulder, like the therapy, is based on the causes of the condition. After an operation, rest and protection are the order of the day. The affected arm should be immobilized for three to six weeks. Physiotherapy is the main activity during this period.
The doctor carries out a passive mobilization, i.e. a movement of the shoulder from the outside. If no complications arise, the treatment can be completed after a final physical examination and a patient consultation. The anamnesis includes the processing of a questionnaire to determine whether the shoulder dislocation has completely subsided.
In the event of complications and persistent symptoms, physiotherapy must be resumed. If necessary, other specialists and sports physicians must be involved in the treatment. The orthopedist or the general practitioner is usually responsible for aftercare. Depending on the course of the symptoms, it takes place three to six weeks after the last treatment.
Further follow-up examinations are usually not necessary. However, the causes of the shoulder dislocation must be treated. Often there is an underlying disease that needs to be clarified. The aftercare of the causative disease depends on the type of suffering and the respective course of the disease and is discussed with the responsible doctor.
You can do that yourself
In the case of a dislocated shoulder, immobilization and avoidance of heavy loads are recommended. Beverage crates and other heavy objects should not be lifted for six weeks. Those affected must temporarily refrain from sports such as swimming or gymnastics. They often lead to an increase in the symptoms.
Ice compresses help acutely. They relieve pain and inflammation in the first few days. Heat packs are then suitable. They help relax a tense muscle. If the pain becomes too severe, over-the-counter medications can be used. Aspirin and ibuprofen promise relief, but should only be taken for a short time.
A doctor orders physical therapy with several sessions. Exercises are given in the sessions. You should fully develop the range of motion of the shoulder again. In order to achieve sustainable results, short and regular units must be integrated into everyday life. It is also advisable to continue for a period after the physiotherapy. Because strengthening the shoulder muscles is the best way to prevent a new dislocation. If people are prone to a dislocated shoulder, a training plan should be drawn up together with the physiotherapist.
