Not surprisingly, the body's most mobile jointjointThe junction or articulation of two or more bones that permits varying degrees of motion between the bones. is also the one that is most frequently dislocated. A sudden blow or a fall can cause this condition. The painpainAn unpleasant sensation associated with actual or potential tissue damage, and mediated by specific nerve fibe... can be severe.

In some individuals, shoulder dislocationdislocationDisplacement of an organ or any part; specifically disturbance or disarrangement of the normal relation of the... continues to happen—creating what is called an "unstable" shoulder.

Shoulder dislocations and separations most frequently happen in younger, athletic individuals. Having had a shoulder dislocation also puts the patient at higher risk for redislocation. The younger the patient is when he or she first dislocates their shoulder, the higher the chance that it will happen again.

dislocation

The shoulder jointjointThe junction between the ends of two adjacent bones. (glenohumeral jointglenohumeral jointTrue shoulder joint.) is made up of a ball and socket joint. The flat boneboneThe hard tissue that provides structural support to the body. It is primarily composed of hydroxyapatite cryst... of the socket has surrounding tissuetissueA collection of similar cells and the intercellular substances surrounding them. called the labrumlabrumA fibrocartilaginous rim attached to the margin of the acetabulum of the hipbone.. The labrum gives it the extra depth it needs to help hold the ball in the socket. Ligaments of the joint capsulejoint capsuleThe sac that encloses a joint, formed by an outer fibrous capsule and an inner synovial membrane. provide additional support.

When the ball comes out of the socket during a dislocation, a portion of the labrum is torn or separated from the socket. This is called a Bankart tear or SLAP lesion, with the name depending on the location of the tear. In addition, the capsule may become stretched.

• A dislocated shoulder happens when a strong force or extreme shoulder rotation pulls the "ball" of the upper arm boneboneThe hard tissue that provides structural support to the body. It is primarily composed of hydroxyapatite cryst... out of the socket. About 90% of all shoulder dislocations are this form of injury, called "anterior dislocation" because the top of the bone slips out in front of the shoulder joint.
• If the dislocation is partial, it's called subluxationsubluxationLooseness or slipping of the femoral head within the acetabulum.. The joint is loose and may slide partially out of place. In this case, the labrum may still be attached, but the capsule is stretched out.

types of shoulder dislocation

There are two types of patients with shoulder instability. Treatment depends on which type of dislocation the patient has:

• Dislocation resulting from injury. When an injury forces the ball out of the socket, treatment to put the ball back into the socket is usually done in an emergency room. If the shoulder dislocates again, surgerysurgeryThe branch of medicine concerned with the treatment of disease, injury, and deformity by operation or manipula... may be recommended.
• Dislocation resulting from looseness in ligaments and shoulders. Some shoulder dislocations reoccur without significant injury. Physical therapyPhysical therapyThe treatment consisting of exercising specific parts of the body such as the legs, arms, hands or neck, in an... to strengthen muscles to help hold the ball in the socket may be useful in these cases. Surgery usually isn't recommended unless therapy has failed after several months.

How is a shoulder dislocation or separation diagnosed or treated?

The doctor will conduct a thorough examination to find the source of the pain:

• When the shoulder is dislocated, the arm will look out of position. Patients will have severe pain, particularly if muscle spasms are present
  • In a partial dislocation (subluxation), patients may have the sensation that their upper arm bone can slip out of its socket. The doctor may order an x-rayx-rayAn X-ray is a painless process that uses radioactive materials to take pictures of bone. If your doctor suspec... to confirm the diagnosis and check for fractures.
• A shoulder separation will involve pain and tenderness. Sometimes a bump will appear in the mid top of the shoulder. The doctor may order an x-ray to confirm the diagnosis and check for fractures. An MRIMRIShort for magnetic resonance imaging. This is a special radiologic test that allows for excellent imaging of t... may be ordered to make sure there are no other injuries.

For a dislocated shoulder, the doctor will treat the problem by placing the "ball" of the upper arm back in the socket—bringing instant relief. This is called a "reduction." The doctor may suggest additional measures including immobilization, ice packs, and a rehabilitationrehabilitationRestoration, following disease, illness, or injury, of the ability to function in a normal or near-normal mann... program of physical therapy to help restore mobility and strengthen the arm. This will help reduce the likelihood of future dislocation.

If you have dislocated your shoulder before, or continue to have problems, your doctor may suggest minimally invasive surgeryminimally invasive surgerySurgery requiring small incision(s), usually performed with endoscopic visualization. called arthroscopic surgery or traditional open surgery to correct the problem.

When the problem is a separated shoulder, your doctor may suggest immobilization, ice packs, and a rehabilitation program of physical therapy to help restore mobility and strengthen the arm.

Most shoulder separations heal within a few months without further treatment. However, sometimes the ligaments are too severely torn to keep the clavicleclavicleThe collarbone. in place. If this is the case, your doctor may suggest surgery.

what can be expected for the long-term?

Most shoulder separations heal within a few months without further treatment. Younger patients remain at higher lifetime risk for a repeat dislocation and may benefit from surgery to repair torn ligaments and prevent additional dislocations.