What is dislocated shoulder?
A dislocated shoulder usually happens after a heavy fall onto the arm.
Dislocating your shoulder means your arm bone has popped out of its shoulder socket and the supporting tissues may have overstretched or torn.
The shoulder is one of the easiest joints to dislocate. This is because the top of the arm bone, which is shaped like a ball, sits in a very shallow socket. While this makes the arm extremely mobile and able to move in many directions, it also means that it’s not very stable.
Most people dislocate their shoulder during a contact sport, such as rugby, or a sports-related accident. In older people, the cause is usually falling onto outstretched hands, for example after slipping on ice.
Shoulder dislocations can occur more easily in people who are very flexible – for example, those with joint hypermobility (loose joints).
How do I know if I have dislocated my shoulder?
In nearly all cases of dislocated shoulder, the arm bone pops out in front of the shoulder socket. This is usually obvious because:
- the shoulder will suddenly look square rather than round
- you may be able to see a lump or bulge (the top of the arm bone) under the skin in front of your shoulder
- you won’t be able to move the arm and it will be extremely painful
It is much more unusual for the bone to pop out of the back of the shoulder joint. This usually happens after an epileptic fit or electrocution injury, and is less easy to spot. Some people who are extremely flexible can dislocate their shoulders in more than one direction.
What you should do
If you think you have dislocated your shoulder, see a doctor immediately. This is important as you will need some tests to find out whether you have any nerve damage.
A doctor will gently manipulate your arm bone back into its socket using a procedure known as reduction.
If your shoulder has dislocated without any major accident and you’ve managed to gently manipulate the arm back into place, there may be no need to go to A&E. However, it’s a good idea to see an orthopaedic specialist, who can check on the shoulder and provide further advice.
Recovering from a dislocated shoulder
After reduction, you’ll need to rest your arm in a sling for a few weeks. You’ll usually be referred to a physiotherapist for rehabilitation to strengthen your shoulder.
Arm and shoulder exercises
Your physiotherapist will show you some gentle arm and shoulder exercises to do at home with your arm out of its sling. These will help reduce stiffness, relieve some of the pain and build up strength in your shoulder muscles.
It is also important to have good posture while in and out of the sling, so you don’t create further weakness around the shoulder.
Gradually increase the range of movement in your shoulder and gently move the arm into positions that challenge the shoulder muscles.
It is normal to feel aching, discomfort or stretching when doing these exercises. However, if you have intense pain for more than 30 minutes, do the exercise less forcefully and less often.
It’s better to do short, frequent sessions of 5-10 minutes four times a day, rather than one long session, and to gradually increase the number of repetitions you do.
The shoulder may be very painful during the first two to three weeks at home and you may need to take painkillers.
If you’ve torn the tissue surrounding the shoulder joint, you may need a steroid injection into the shoulder to reduce the pain and inflammation.
You’ll need to wear the sling for a few weeks.
You can usually resume most activities within two weeks, but avoid heavy lifting and playing sports involving shoulder movements for six weeks to three months.
You’ll probably be off work for two to four weeks, or longer if you have a physical job. Discuss this with your doctor.