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.