What to Know About Dislocated Shoulder Injuries
The shoulder joint has the greatest range of motion in the entire body which makes it extremely susceptible to being dislocated. Shoulder dislocation happens when the ball of the humerus separates from the shallow shoulder blade socket. This is commonly caused by a hard blow to the shoulder along with sudden abduction of the upper arm. It is often reported by active individuals who participate in contact sports such as hockey, basketball and football, and in sports that can cause falls such as skiing, gymnastics and even volleyball. Dislocated shoulder treatment must be sought immediately after the injury happens to avoid causing further damage to the joint.
A shoulder injury can either be a dislocation or a subluxation depending on the extent of displacement. In both cases, the injured person will report a myriad of symptoms that includes hearing a “pop” at the onset of the injury, intense pain, muscle spasms, numbness and inability to move the arm. Because of the swelling, the pain increases to the point that some patients pass out. Objectively, the appearance of the affected shoulder is odd or “squared off” and consequently longer that the other.
Immediately after the injury occurs, the joint should be stabilized and movement should be limited. A splint or shoulder sling can be used to keep the shoulder in its current position. Never try to move it or attempt to put the arm back in place as it can damage the surrounding muscles, nerves, ligament, blood vessels and the joint itself. While the patient is on his way to the emergency room, bring an ice pack that can be applied to the area to reduce the swelling and pain. This will also control the fluid build-up around the shoulder.
When the patient is finally at the hospital, the doctor’s first course of action is to perform closed reduction where he gently maneuvers the dislocated shoulder back to the socket. Because of the pain, the patient will most likely be under anesthesia during the procedure. This type of dislocated shoulder treatment includes scapular manipulation where health care professionals rotate the shoulder blade to allow spontaneous relocation. External rotation or the Hennepin maneuver is also a form of closed reduction where the elbow is flexed at 90 degrees and the shoulder is gradually rotated outward.
Another closed reduction procedure is the traction-counter traction where a sheet is circled around the armpit. One health care professional pulls down the affected arm while counter traction is applied by another heath care professional as he pulls on the sheet at the head of the bed. This procedure allows the shoulder muscles to relax which enables the humeral head to return to its original position. The intensity of the pain is immediately reduced once the ball of the humerus is returned to its socket.
Open reduction is also a dislocated shoulder treatment that involves invasive surgery used only when closed reduction attempts are unsuccessful. Prior to the procedure, patients are given procedural medications that allow the muscles to relax and reduce pain thus enabling a successful surgery. Just like the other methods, treatment does not end after the reduction. The shoulder will need rest for a few weeks with the help of immobilization and gradually strengthened through passive and active exercises once it is safe to move it.