Shoulder Dislocation and Shoulder Instability
A dislocated shoulder requires immediate care to reposition your shoulder, relieve your pain, look for additional concerns -- such as fracture or tendon, ligament, or labral damage -- and prevent future complications. Duke’s shoulder surgeons work closely with young athletes who suffer shoulder dislocations during sports, as well as older people debilitated by repeated shoulder dislocations and instability from years of wear and tear. When surgery is needed, we have extensive experience performing the latest advances in shoulder surgeries. Our goal is to help you return to your daily activities and optimum sports performance.
Why Shoulder Dislocation Needs Prompt Treatment
Falls and hard blows to the shoulder that occur during sports or trauma are the primary triggers for popping the top of your arm bone from the shoulder joint. It’s commonly seen in athletes involved in volleyball, football, soccer, hockey, basketball, wrestling, and rock climbing -- sports that require overhead reaching and stretching. However, shoulder dislocation can also occur spontaneously if the connective tissue in the shoulder is naturally loose.
- In severe cases, a dislocated shoulder can damage and even tear the surrounding tendons or ligaments.
- In most cases, shoulder dislocations are painful and need prompt treatment to reposition the shoulder and prevent ongoing pain as well as future problems. A shoulder that doesn't heal properly can become weak, unstable, and more likely to dislocate again -- sometimes with everyday movements like rolling over in bed. Shoulder instability can also occur when ligaments are naturally loose, or when they are damaged from repeated motions like throwing a ball, lifting heavy objects, or being hit in the shoulder during sports.
- If you need immediate care, see a Duke shoulder surgeon right away. Appointments are often available within 24 hours. You can also get immediate care at Duke Orthopaedic Urgent Care, which is available seven days a week at two convenient locations.
Understanding Your Shoulder Dislocation Treatment Options
Your shoulder surgeon will evaluate your condition and use imaging tests, such as X-rays, to look for dislocated joints and fractures of either the ball or socket of the shoulder. An MRI with dye in the joint may be needed to assess damage to the cartilage, tendons, and ligaments of the shoulder joint. Precise maneuvers will return the shoulder to its proper position. Rest, ice, muscle relaxers, and pain medication may reduce pain and swelling.
If you have recurrent shoulder dislocations or are diagnosed with shoulder instability, surgery to stabilize the shoulder may be recommended. As specialists who undergo advanced training in treating and mending the shoulder joint, Duke shoulder surgeons are equipped to perform several different types of shoulder surgeries. Your individual needs -- including your age, activity level, and the extent of your injury -- are factors that will help your shoulder surgeon determine which procedure is best for you.
Physical therapy and strengthening of the shoulder muscles are often the mainstays of treatment for some forms of shoulder instability, such as cases where the shoulder ligaments are lax and there was no trauma to the shoulder. This is commonly seen in volleyball players and swimmers. Physical therapy will help you regain strength in your shoulder, relieve your pain, and improve your shoulder function. Duke has physical therapists on staff who specialize in shoulder injuries. They will tailor exercises to help you return to -- and possibly improve -- your sports performance. You will also learn to adopt new habits to reduce your chance of re-injury.
SHOULDER DISLOCATION AND INSTABILITY
Recurrent shoulder dislocations and chronic shoulder instability may be corrected with a surgical procedure. Most are performed using an arthroscope, a tiny camera that is inserted through small incisions into the shoulder joint. Shoulder arthroscopy is a minimally invasive procedure that results in less pain. Traditional open surgery, which requires larger incisions, may be necessary for complex shoulder problems.
Also known as arthroscopic labral repair, this common procedure repairs tears to the labrum -- the ring of cartilage around the edge of your shoulder socket. It restores stability to shoulders that don’t have extensive damage from repeated dislocations. If there is extensive injury to the labrum or the bone of the socket joint, an open Bankart Repair might be recommended.
This arthroscopic procedure repairs a dent in the ball part of the shoulder joint that can result from a dislocated shoulder. This defect can cause the shoulder to dislocate again. This procedure may be combined with the Bankart repair.
The bone at the front of the shoulder socket can become chipped or worn away from repeated dislocations. Your shoulder surgeon may use this technique to transfer a piece of bone and muscles from another part of your shoulder and attach it to the damaged area. Together they keep the ball at the top of your upper-arm bone from slipping out of your shoulder socket. This procedure has proven successful in preventing future dislocations.