A partial dislocation (subluxation) means the head of the upper arm bone (humerus) is partially out of the socket (glenoid).
A complete dislocation means it is all the way out of the socket.
The shoulder joint can dislocate forward, backward or downward. The most common type of shoulder dislocation is when the shoulder slips forward (anterior instability). This means the upper arm bone moved forward and down out of its joint. It may happen when the arm is put in a throwing position.
Dislocated shoulder symptoms
- The immediate treatment for a dislocated shoulder is a closed reduction. During a closed reduction, the physician will place the ball of the upper arm bone back into the joint socket. Severe pain stops almost immediately once the shoulder is back in place. This can sometimes be done on the field but often requires a trip to the ER to have the reduction done with sedation.
- After the shoulder is reduced, the patient is placed in a sling. The sling is used for one to three weeks based on the comfort level of the patient. First time dislocators can have a trial of non-operative treatment. This consists of activity modification and physical therapy to regain range of motion and strengthen the dynamic stabilizers of the shoulder (the rotator cuff and scapular muscles). Bracing can sometimes be helpful for players returning to contact sports to help prevent recurrent dislocations.
- In patients with recurrent instability or athletes participating in contact sports, surgery may be recommended to help stabilize the shoulder.
Surgery for shoulder dislocations/instability
is typically done arthroscopically (using a camera and instruments through small skin incisions). The labrum is mobilized and the bone along the rim of the socket (glenoid) is prepared to help stimulate healing of the soft tissue. Anchors, with high strength sutures in them, are placed in the bone and the sutures are passed around the labrum and capsule to secure it to the bone. This ‘tightens’ the shoulder and re-creates the bumper effect of the labrum to prevent dislocation of the shoulder.
Often referred to as an open Bankart repair, this involves a longer incision in the front of the shoulder and similar techniques using anchors to tension the capsule and repair the labrum.