Shoulder Dislocation Treatment
The shoulder is the most mobile joint in the body and the one that dislocates most often. A first dislocation needs proper care, and recurrent ones may need stabilising surgery.
The shoulder’s wide range of motion lets us lift the arm in almost every direction. The price of this mobility is that its stability is more easily lost. A shoulder dislocation is when the head of the upper arm bone (humeral head) comes completely out of the socket, most often forwards.
How does the shoulder dislocate?
Falling onto the arm, being forced while the arm is raised and turned outwards, or a blow in contact sport are the most common causes. Young patients are more likely to dislocate again after a first dislocation. In older people, a dislocation may come with a rotator cuff tear.
Symptoms
- Sudden, severe shoulder pain
- A change in the shape of the shoulder, with a hollow at the top
- Inability to move the arm
- Sometimes numbness or tingling in the arm (nerve involvement)
First steps
A dislocated shoulder should be put back in place at a medical facility as soon as possible. Attempts by untrained people to pull or twist the shoulder back can cause fractures and nerve or blood vessel injury. The best approach is to keep the arm close to the body and still, and seek care.
Diagnosis and reduction
Examination and X-rays show the direction of the dislocation and whether there is a fracture. The shoulder is put back in place (reduction) with appropriate pain control or sedation. A check X-ray follows and the nerves and circulation are re-examined. In young patients and in recurrent dislocations, MRI is used to assess the capsule, labrum and any bone damage.
Treatment options
After a first dislocation
A sling for a short time is followed by physiotherapy focused on movement and strengthening. The aim is to stabilise the joint by strengthening the muscles around the shoulder.
Surgery for recurrent dislocation
If the shoulder dislocates repeatedly, or a feeling of instability limits daily life, surgery is considered. The torn labrum and loose capsule are stitched back arthroscopically (Bankart repair). In patients with significant bone loss from the socket, bone block transfer procedures such as the Latarjet may be preferred.
Recovery
After surgery the arm stays in a sling for a few weeks, and controlled range-of-motion exercises are started. Returning to daily activities usually takes a few weeks, and returning to contact sport usually takes a few months.
The role of physiotherapy after dislocation
After a first dislocation, exercises that strengthen the rotator cuff and shoulder blade muscles improve joint stability. The programme is progressed step by step: first pain-free range of motion, then strength and finally sport-specific movements. Doing the exercises regularly helps reduce the risk of another dislocation.
Frequently asked questions
My shoulder dislocated once. Will it happen again?
The chance of another dislocation is higher in young, sporty people. This is why proper rehabilitation, and an MRI when needed, are important after a first dislocation.
Can a dislocated shoulder be treated without surgery?
Most first dislocations are treated without surgery. In recurrent dislocations, surgery is more effective at restoring stability.
When can I return to sport after surgery?
Non-contact sports can be resumed earlier, and contact sports once muscle strength and joint stability are adequate, usually after a few months.
How long is a sling worn after a dislocation?
Usually for a short time after a first dislocation. Because long immobilisation can stiffen the shoulder, the duration is set individually.
The information on this page is general and does not replace an examination. An examination is needed to decide which treatment suits you.