Traumatic Shoulder Dislocation Causes, Symptoms & Treatment

Overview

Shoulder dislocations occur when the head of the humerus (the long bone of the upper arm) completely leaves the glenoid cavity(socket) of the shoulder.. Although the shoulder joint allows a greater range of motion for athletic activities, it is also at a higher risk of dislocations.

 A traumatic shoulder dislocation occurs when the humeral head is pushed out of the socket due to an impact, such as a tackle in football, or a traumatic injury, like a fall. This type of shoulder joint dislocation is common, especially among athletes involved in contact sports.

The shoulder can become dislocated in one of two directions:

• Anteriorly (through the front of the joint)
• Posteriorly (through the back of the joint)

Anterior shoulder locations are much more common than posterior shoulder locations.

What causes Traumatic Shoulder Dislocation?

Shoulder dislocations usually occur from a fall on an outstretched arm and are very common in collision sports.

• How the Injury Occurs: A traumatic shoulder dislocation happens when the humeral head is forcibly pushed out of the glenoid cavity due to sudden impact, awkward falls, or extreme twisting of the arm. The injury often results in intense pain, swelling, and an inability to move the shoulder normally.
• Common Everyday Causes: Outside of sports, shoulder dislocations can occur from falling on an outstretched hand, slipping on stairs or wet surfaces, motor vehicle accidents, or lifting heavy objects improperly. These incidents create enough force to overwhelm the shoulder’s natural stability, causing the joint to pop out of place.

Traumatic Shoulder Dislocations are common in these sports:

• Boxing: Direct punches or falls can force the shoulder out of its socket.
• Football: Tackles and collisions often cause sudden shoulder displacement.
• Ice hockey:  Body checks or falls on the ice can lead to dislocations.
• Lacrosse: High-impact contact or falls while running can dislocate the shoulder.
• Rugby: Tackling and scrums can exert extreme force on the joint.:

• Baseball: Overhead throws or collisions while sliding may cause dislocation.
• Basketball: Falling awkwardly or contacting during a rebound can dislocate the shoulder.
• Volleyball: Diving or hitting the ball at full stretch may lead to dislocation.

Symptoms

Traumatic shoulder dislocations are often extremely painful and usually obvious. You may have a dislocation if, after an injury, you notice dislocated shoulder symptoms:

• Visible deformity – The shoulder appears out of place or misshapen.
• Swelling or bruising – The area around the shoulder may swell and show discoloration.
• Limited movement – You may be unable to lift, rotate, or move your arm normally.

Anterior shoulder dislocations frequently cause a Bankart lesion, which is a tear in the lower portion of the glenoid labrum. The labrum is a ring of cartilage inside the shoulder socket that deepens the glenoid cavity, helping the humerus fit securely and stabilizing the joint. Posterior dislocations can cause a similar tear in the back of the labrum, known as a Kim lesion.

Other complications from traumatic shoulder dislocations can include:

• Nerve damage – Injury to nerves around the shoulder, which may cause weakness or numbness.
• Muscle or tendon tears – Damage to the rotator cuff or other surrounding tissues.
• Fractures – Breaks in the bones around the shoulder joint.
• Shoulder instability – Recurrent dislocations or partial dislocations (subluxations) over time.

Having one traumatic shoulder dislocation increases your risk of future dislocations. The likelihood of recurrent shoulder dislocations depends largely on age: dislocations in people under 20 years old have a high chance of repeating, whereas dislocations after age 40 are less likely to recur.

Non-operative treatment

If it is your first dislocation and there has been no damage to the surrounding structures of the shoulder joint, your doctor will most likely suggest conservative or non-surgical treatment to strengthen the shoulder muscles. You will begin a physical therapy program with a licensed professional to strengthen and stabilize the shoulder muscles. In some circumstances, in high-demand athletes, surgery after the first incidence of dislocation is recommended.

Try these exercises to help address your condition:

Below is a PDF of the Exercise Program

Traumatic Shoulder Dislocation

Surgical Treatment

If you have injured the muscles or ligaments of the shoulder, you may need surgery to repair damaged tissue and/or to tighten any ligaments that are stretched out. If you have more than one dislocation, surgery is often  suggested to stabilize the shoulder.

The type of procedure performed will depend on many factors, including:

• Whether the shoulder is dislocating out of the back or the front of the joint
• If there is any damage to the bone
• The number of times the shoulder has been dislocated

Generally, in simple cases, surgery can be done arthroscopically. Arthroscopic surgery is a minimally invasive surgical technique that uses several tiny incisions (roughly one centimeter long) through which special instruments and a camera, attached to a thin, flexible tube, are inserted. During arthroscopic surgery, the physician repairs the damage by putting stitches in the torn tissue. In complicated cases, a more classic open procedure is needed to restore the stability of the shoulder joint.