Shoulder dislocations typically occur from sudden jarring motions while the shoulder is in a compromised position. An auto accident, fall off a bicycle, or collision while playing sports are common examples of situations that can cause dislocations. For those of us who are naturally hyper-flexible, it may take much less force to cause a dislocation. I saw a patient last month who dislocated her shoulder simply by sneezing. Ouch.
The shoulder is an inherently unstable joint. The humerus, or upper arm bone, is shaped like a ball at the top and loosely fits into the shallow socket-shaped scapula. There are a series of ligaments, muscles, and other soft tissue structures that help to hold the humerus in place, but there is still a large amount of freedom in the joint. The shoulder joint can move in almost all directions which allows us to throw a baseball, spike a volleyball, hang from a pull-up bar, and reach behind our backs to scratch an itch. This freedom of motion comes at the expense of overall stability.
Shoulder dislocations most often occur “anteriorly,” meaning that the head of the humerus bone spills out of the joint in a forward direction. The above photo of a baseball pitcher is an example (albeit an extreme one) of a dislocation position.
If you have dislocated your shoulder, it is a good idea to work on strengthening the surrounding muscles once you are cleared by your doctor to begin exercise. It is of vital importance that you do not place your arm in extreme positions during the early phases of rehab. Stick to “isometric exercises” at first. Isometrics involve placing resistance on the muscles of the shoulder while the shoulder itself is not moving. (See shoulder exercise #10).
Most orthopedic surgeons will agree that if shoulder dislocations occur multiple times within the scope of a few years despite conservative management, surgery is in order. Dislocations will very often coincide with tearing of the “labrum” of the shoulder. The labrum is a cartilaginous ring that surrounds the socket and provides additional stability to the joint. Once the labrum is torn, there is even less stability in the shoulder and active motions are more likely to become chronically painful despite strengthening around the joint. The labrum can be surgically repaired and normal function restored, but it is indeed a long process that requires diligence and patience.
Make sure that you have pursued a conservative approach that involves strength training prior to considering surgery if you have suffered a shoulder dislocation!
Read More About Shoulder Issues
• What Does a Shoulder Labral Tear Feel Like?
• How Do I Stabilize an Unstable Shoulder?
• When Can I Start Working Out After Shoulder Surgery?
• Is Sleeping On My Side Bad For My Shoulder?
• Why Won’t My Shoulder Rotate?
• Managing Expectations When Recovering from a Labral Repair
Credits: Image by Alex King.
Nice blog thanks to share this all information here…
I’m 29, and have had a handful of dislocations in my left shoulder over the years, starting from age 8 or so. Each time I’ve been able to reduce it myself within a few seconds, and each time there is some soreness after, but no extreme pain. I had two dislocations last year, from relatively benign movements. I’m on the fence about surgery because although I’m now hyper aware of that shoulder and really baby it, I’m not in any pain and I can do activities like running/yoga without a problem. Is surgery in this case a no-brainer? Are there risks to delaying or opting out of surgery, down the road (besides further dislocations)?
The generally accepted notion is that the surgery is a good idea if you are dislocating consistently once or more per year. It sounds to me like you fall in to the “grey area”. At the very least I would work on strengthening the muscles that stabilize that anterior portion of the shoulder, namely the subscapularis. (I am going to assume that you are an anterior dislocater??????)
It is worth your time to visit a physical therapist once to get a battery of exercises to do. If you are indeed an anterior dislocater, you could benefit from the “Internal rotation” exercise in our shoulder exercises on the website. The password to get in is “patient”.
Remember though, you need to have a doc or a PT check out the shoulder to assess which way you tend to dislocate. I cannot diagnose your pattern of instability over the internet. That would be a bad idea.
I am 15 years old and play volleyball competitively. I have dislocated my arm they believe for the first time last year or so. Because I chose to not see a sports medicine doctor in fear of being sat out for a couple games. Now a year later my pediatrician ordered a X- Ray (nothing broken) and a sling in February for 2-3 weeks with not activity. I went back to playing after that and around April I got sent to PT who told me I should go see a Orthopedic sports medicine doctor and I did he ordered the standard 6 weeks of PT (no physical activity) to see if any changes occur ( was prescribed Naproxean 500 mg for pain) and if it still hurts he will inject some dye into my shoulder for the MRI to look for the suspected labral tear and then I will have to get surgery and miss all of school and travel season for a full recovery. I am really stubborn but am in a lot of pain and my PT is not working because my muscles are so tired and I do this thing where I unintentionally flex my back shoulders and it has started to make a “pop” sound and dislocate. Should I just get the surgery if there is a tear and what is the chances I will be able to even play the same?
If you were to overhead spike my guess is that you would eventually dislocate again. When there is a dislocation, it is very likely that there is a labral tear present. If you want to continue high-level sports at some point in the future you should probably have the work done. You might get back to the level you were at before prior to the injury because of your young age, but there are no guarantees. Volleyball by the way is also a high-risk sport for shoulder instability, so that is also something to consider.