Shoulder Dislocations

A dislocated shoulder is when the upper arm bone is pulled or pushed out of the shoulder blade socket, or glenohumeral [gleh-no-HUUM-ehr-uhl] joint. A serious dislocation can damage the tendons and ligaments that hold it in place. Dislocated shoulders are a common sports injury, but can also happen if you receive a hard blow to the shoulder in a car accident or a fall.

A dislocated shoulder is when the upper arm bone is pulled or pushed out of the shoulder blade socket, or glenohumeral [gleh-no-HUUM-ehr-uhl] joint. Shoulder dislocations are the most common kind of joint dislocation. There are 3 different types of shoulder dislocation:

• Anterior (forward). The head of the arm bone (humerus) is moved forward, in front of the socket (glenoid). This is the most common type of dislocation and usually happens when the arm is extended.
• Posterior (behind). The head of the arm bone is moved behind and above the socket. This is an uncommon type of dislocation that is usually caused by seizures or electrical shock.
• Inferior (bottom). The head of the arm bone is pushed down and out of the socket toward the armpit. This is the least common type of dislocation.

A shoulder dislocation may cause damage to the surrounding tissues, including:

• Ligaments
• Cartilage
• Tendons
• Muscles
• Nerves
• Blood vessels

Severe shoulder dislocations may require surgery to repair.

The symptoms of shoulder dislocation include:

• Malformation (looks like it’s out of place)
• Swelling
• Bruising
• Intense pain
• Inability to move it

Other symptoms may include:

• Weakness
• Numbness
• Tingling in other areas like the neck and arm
• Spasms in the muscles that make it hurt worse
• Tearing of the muscles around the shoulder joint • Damage to blood vessels or nerves • Instability in the shoulder, especially if you’ve had multiple dislocations

Some of these symptoms can also be signs of other serious injuries, like sprains or bone fractures in your arm, shoulder, back, or upper chest.

Dislocations may be difficult to spot in certain people, such as the elderly or anyone who has been in a traumatic accident.

Seek emergency care if you:

• Have fallen or suffered a blow that has caused pain in your shoulder
• Can clearly see that the shape is not right
• Can’t move the arm without pain 

Shoulder dislocations happen when too much stress is put on the shoulder joint, causing the arm bone to slip out of place. This stress can be caused by:

• A forceful blow during sports like football or a car accident
• Falls

Dislocating your shoulder once weakens the joint and makes it more likely that it will be dislocated again in the future.

Your doctor will ask about your injury and perform a physical exam. Imaging tests, such as x-rays, CT (Computed tomography) scans, or MRI (magnetic resonance imaging) scans may be needed to confirm the location and severity of the injury or to check for additional damage.

If you have a more serious injury, your doctor may suggest that you see a surgeon. This is more likely the case when there may be nerve or blood vessel damage in the area.

Treatments for a dislocated shoulder include:

• Closed reduction. The doctor will try to put your shoulder back in place by moving your arm in a certain way. Pain medicine may be given before the procedure to reduce discomfort.
• Surgery. This may be recommended if you have a weak shoulder joint or have had many dislocated shoulders in the past. Surgery can help tighten and stabilize the surrounding tissues that help to hold the arm bone in place.
• Immobilization [ih-MOH-buh-lih-zay-shun]. The doctor may use a splint or a sling to keep your shoulder still. You may need to wear the splint or sling for a few days or a few weeks, depending on how badly the shoulder is hurt.
• Medicine. The doctor may prescribe medicine to help you manage your pain while you get better.
• Rehabilitation. Once the sling has been taken off, you may need physical therapy to help get your shoulder back to normal.

During your recovery, it will help to:

• Rest. Keep the shoulder rested, and don’t lift heavy things or lift your arm above your head until the doctor says it’s okay.
• Use ice and heat. Put ice or frozen veggies on your shoulder for 15-20 minutes a day for the first 2 to 3 days. Then, when there is less pain, it may help to put heat on the shoulder for 15-20 minutes, 3 to 4 times a day.
• Take pain relievers. Over-the-counter medicine like ibuprofen, aspirin, or acetaminophen can help with pain. Be sure to follow the directions on the pill bottle or ask your healthcare provider if you’re not sure.
• Exercise as recommended. Do all exercises prescribed by your healthcare provider or physical therapist as they will help to keep your shoulder from getting stiff. Keep up the stretches even after your shoulder has healed. These stretches can help keep your shoulder from dislocating again.

You may be able to prevent another dislocation by taking basic steps to keep yourself safe and avoid stressing your shoulder joint. These steps may include:

• Avoiding falls when possible
• Wearing pads and gear when playing sports
• Exercising to keep your shoulder strong and flexible

American Academy of Orthopaedic Surgeons: Dislocated Shoulder