shoulder SHOULDER DISLOCATION

DEFINITION:

The separation of the head of the humerus from the socket (glenoid). (See illustration).
The most common joint to dislocate secondary to its unique anatomy allowing extensive movement of the shoulder.

MECHANISM OF INJURY / HOW IT OCCURS:

A result of a traumatic event where the surrounding soft tissues of the joint are stretched/torn, allowing the head of the humerus to dislocate from the glenoid.

SYMPTOMS:

Immediate pain exacerbated with any attempt at movement of the shoulder.
Inability to move arm. (Player comes off field supporting arm).
May experience numbness/tingling secondary to nerve irritation, usually transient.

DIAGNOSIS:

Physical examination will reveal flattening of the lateral (outer) aspect of the shoulder a result of the shifting of the humeral head.
Radiographic evaluation to confirm direction of the dislocation as well as to evaluate for possible fracture. After relocation of the shoulder repeat x-rays are necessary to confirm reduction.
Magnetic Resonance Imaging (MRI) may be considered as a traumatic dislocation can also result in a rotator cuff tear, especially in those over 40.

TREATMENT/REHABILITATION:

Relocation, often necessary in the emergency room, may require sedation.
Rarely requires surgical relocation.
Sling after relocation for short period, followed by rehabilitation to improve strength and stability. (See exercises for shoulder dislocation).