What is a shoulder dislocation?
A dislocated shoulder means that the bone is out of its socket. Some refer to this a separated shoulder.
Most shoulder dislocations are anterior which means it is pushed out forward. Only about 10% are posterior.
Quickcare or ER?
RED FLAGS that will send you to the ER:
- Severe pain symptoms will generally direct most persons to the ER.
- Also, in order to treat the dislocation, the medications may make patients very sleepy and the breathing erratic. Thus, they need to be on a monitor with oxygen. Hence, the ER is best facility to treat shoulder dislocations.
What will your doctor ask?
Your doctor wants to know your symptoms. Remember, a symptom is your description of your condition to your doctor. It is your story.
Answering the following questions will help your doctor understand your condition.
How bad is the pain?
What makes it better?
What makes it worse?
Can you move your arm?
Did you injure other parts like your neck?
Is the wound open and bleeding?
What is your doctor looking for?
Your doctor will look for signs. Remember, a sign is an objective finding that a doctor discovers on examination.
With a more common anterior shoulder dislocation, the shoulder appears flatter when compared to the opposite side.
A simple trick taught to me many years ago…..If the patient can touch their opposite shoulder with their hand of the affected shoulder, then there is no dislocation.
The doctor will want to know if there is a fracture or dislocation or both. Thus, an xray will be necessary.
What is your doctor thinking?
Your doctor will create a mental list of possible reasons for your signs and symptoms. This list is called a differential diagnosis.
Along with a dislocation, your doctor will consider a broken bone in or around the joint.
Furthermore, a nerve (axillary) may be injured causing numbness over the shoulder.
Before any pushing or pulling on the shoulder is done, your doctor will want to make sure there is nothing broken.
Other injuries to consider are joint separation of the collar bone
How long will you be sick?
The dislocated shoulder can be fixed fairly quickly. A few techniques can be employed to pop it back in.
Once in, I put my patients in a sling for support
An appointment is needed with an orthopaedic doctor.
Dislocated shoulder recovery time is typically weeks. Initially, there is great shoulder instability. I will not have my patients engage in active sports until they are cleared by orthopaedics.
Regular contact sports will be delayed until cleared by the orthopaedic doctor
Let me tell you a story
Tony was the nicest kid in the neighborhood. One day he took a good long look around at his surroundings. He constantly saw unruly, rude kids whose sole purpose was to be disruptive to their parents and gross out the other kids. Each day was a notch higher in disgust.
But Tony was different. He often said to his mother and father, “I think I will go to Stanford and be a doctor.” Everyone laughed. There were no doctors in the family; Only common laborers. And Stanford? The school was across the freeway from the house but a world away.
Still, Tony could not see himself living in that neighborhood and acting like the other kids. He had something that they did not have. He had a dream.
With a few scouts scheduled to check out Tony’s skills, tragedy struck. It was a simple fall on the shoulder after a routine tackle. No snap like a break. This sound was more a “thud.” Something was not right. Tony’s arm clung to his side. His shoulder spasmed. All his muscles cramped up.
Luckily, when he showed on a Friday night, it so quiet. No fights. No trauma. That night, it was as if the whole ER was built for him and the entire staff at his service.
Tony’s shoulder must be checked to see if it is broken or dislocated.
With some relaxing medications injected, externally rotating his shoulder was all that was needed. The “clunk” sound of a reduced shoulder echoed.
With his playing days extended, the golden ticket scholarship followed as planned.
I hope this helps