A dislocated shoulder happens when your upper arm pops out of your shoulder socket.
The shoulder is one of the easiest joints to dislocate because the ball joint of your upper arm sits in a very shallow socket. This makes the arm extremely mobile and able to move in many directions, but also means it isn't very stable. In some cases, the surrounding tissues supporting the shoulder joint may also be overstretched or torn.
A dislocated shoulder can take between 12 and 16 weeks to heal after the shoulder has been put back into place
Symptoms and Diagnosis
You can dislocate your shoulder if you fall on to your arm heavily. Most people dislocate their shoulder while playing a contact sport, such as rugby, or in a sports-related accident.
In older people, the cause is often falling on to outstretched hands – for example, after slipping on ice.
Shoulder dislocations can occur more easily in people who are highly flexible, such as those with loose joints (joint hypermobility). In most cases of dislocated shoulder, the ball part of the joint pops out in front of the shoulder socket. This is usually obvious because you won't be able to move your arm and it will be very painful, your shoulder will suddenly look square rather than round, you may be able to see a lump or bulge (the top of the arm bone) under the skin in front of your shoulder.
It's much more unusual for the bone to pop out of the back of the shoulder joint. This can usually happen after an epileptic fit or an electrocution injury, and is less easy to spot.
When you go to accident and emergency, you will be sent for an x-ray to confirm that you have dislocated the shoulder and to see if there are any other damaged structures.
Firstly the main aim is to protect the shoulder joint, prevent further damage and to seek medical attention as soon as possible as you need your shoulder to be put back in place by a medical professional.
Seek medical attention immediately. Go to a hospital emergency room or find a doctor as soon as possible. Do not delay! Do not move the shoulder joint. Immobilized in a sling if possible to protect it from further damage.
Applying ice or cold therapy may help with pain and swelling. Do not apply ice directly to the skin and when applying avoid moving the joint. Ice can be applied for 10 to 15 minutes every hour initially, reducing frequency as required.
Reduction is where the dislocated humerus bone is put back into the joint. The shoulder should be reduced or put back into place only by a trained medical professional as soon as possible. Never attempt to pop it back yourself as you may cause further damage! If the reduction is difficult it may be necessary to conduct the procedure under anesthetic.
After the shoulder is put back into the socket, you will have another x-ray to make sure it as gone in successfully and without damaging or impeding any other tissue/bone.
The joint needs to rest after relocation. For the following week, aim to just move the shoulder around the range of motion, do this slowly and always under control. The shoulder joint is very weak now and very prone to re-dislocation.
After a few days you can start to add strengthening exercises. These must never be rushed however they need to be done as the muscles around the socket need to be stronger to help keep the joint in the socket.
Isometric shoulder exercises - Isometric means without movement, also known as static contractions. These are exercises where the muscles are being worked without moving the joint.
Isometric extension - Standing with your back against a wall, with your arms by your side. While keeping your elbows and wrists straight, push back into the wall and hold for 5 seconds. Work to increase this to 10 seconds. Repeat this 5 times.
Isometric Flexion - Standing with your front against a wall, with your arms by your side. While keeping your elbows and wrists straight, push forward into the wall and hold for 5 seconds. Work to increase this to 10 seconds. Repeat this 5 times.
Isometric adduction - With a small pillow or a rolled up newspaper between your injured arm and your torso, squeeze inwards and try to hold it in position. Start with a small item and gradually move to larger sizes to work through a larger range of movement. Hold for 5 seconds (work to increase to 10). Repeat this 5 times (work to increase to 10).
Isometric Abduction - Stand side-on to a wall, with the arm to be worked next to it. Place the back of the wrist against the wall and push outwards as if trying to raise the arm to the side. Hold for 5 seconds (work to increase to 10). Repeat this 5 times (work to increase to 10).
Isometric External Rotation - Stand facing a door frame. Keep the elbow bent to 90 degrees and place the back of the hand against the frame. Push against the it. Hold for 5 seconds (work to increase to 10) and repeat 5 times (work to increase to 10).
Isometric Internal Rotation - Stand facing a door frame. Bend the elbow to 90 degrees, and place the palm of the hand on the side of the door frame and push against it. Hold for 5 seconds (work to increase to 10) and repeat 5 times (work to increase to 10).
Once these exercises start to become easy and you can achieve full range of motion without any apprehension or discomfort, you may move onto the next stage of rehabilitation.
Resistance band internal rotation. - Start with the band attached to a fixed point to your side and hold the other end of the band in one hand, with the elbow bent and upper arm by your side. Keeping the elbow by your side, move your hand towards your stomach as far as is comfortable then slowly return to the starting position. Start with 1 set of 10 and keep increasing with time.
Abduction - Stand on one end of the band and hold the other end. Keeping the elbow straight, pull your arm out to the side so that the hand ends up level with your shoulder. Start with 1 set of 10 and keep increasing with time.
Flexion - Stand on the band holding the other end in the hand of your injured arm. Keeping the elbow straight, pull your hand straight up in front of you to about shoulder height. Once the athlete is comfortable with the exercises above, the resistance band can be replaced with weights to progress the strengthening exercises described above. Start with 1 set of 10 and keep increasing with time.
Adduction - Wrap the band around something secure, hold the other end and stand with your injured side closest to the attachment. Keeping the elbow straight, pull your hand across your body as far as is comfortable. Start with 1 set of 10 and keep increasing with time.
External Rotation - Externally rotating the shoulder before it is ready puts it at risk of dislocation. Wrap the resistance band around something stable and hold the other end standing so that the band crosses the body. Keeping the elbow bent to 90 degrees and the upper arm by the side, rotate the shoulder to pull the band away from the body. Start with 1 set of 10 and keep increasing with time.
Shoulder press - Stand on the center of the band and hold the ends in either hand. Start with the elbows bent and hands at shoulder height. From there, straighten your arms and push up above your head. Slowly return to the starting position and repeat. Many of these exercises can also be performed with free weights as your strength progresses. Start with 1 set of 10 and keep increasing with time.
After time you will be able to continue with everyday life and sport. Your shoulder will hopefully be strengthened enough so it doesn't dislocate again. However the chance of dislocating again is always higher after previous dislocations.