Monday Medical: Shoulder dislocation — What to know
Steamboat Pilot & Today
You know the feeling: you’re carving your skis on the mountain or maybe just walking across an icy parking lot, then suddenly you lose balance and start to fall.
The last thing you want is to dislocate your shoulder. But is there anything you can do to prevent it? Dr. Andreas Sauerbrey, an orthopedic surgeon in Steamboat Springs and a member of the medical staff at UCHealth Yampa Valley Medical Center, answers that question and more below.
What causes the shoulder to dislocate?
“It frequently happens with a hard fall, in which your arm is up and behind you or you land on your shoulder,” Sauerbrey said.
The force of the fall causes the ball of the arm bone to come out of the socket, which Sauerbrey compares to a golf ball falling off of a tee.
“The shoulder inherently is not a stable joint,” Sauerbrey said. “It allows for a lot of mobility, but that means it’s prone to instability.”
Can I prevent it?
Most likely, no, though tucking the arm in during a fall should make it less likely you’ll knock the shoulder out of place.
What do I do if it happens?
In most cases, you should be immediately seen by a doctor as there’s a risk that a bone is also fractured.
“You should have an X-ray before having it put back in,” Sauerbrey said. “Because, if the bone is broken, and we try to put it back into place, suddenly we’ve turned a simpler situation into something way more complicated.”
You’ll most likely know if you’re shoulder is actually dislocated. “It’s excruciatingly painful,” Sauerbrey said.
Who’s most at risk?
People who are young or double- or loose-jointed are more at risk for shoulder dislocation. Shoulder dislocation happens more frequently in snowboarding than in skiing and is most common among people who participate in higher impact sports, such as freestyle skiing and football.
“The riskier your sport and the more exposures to falling, the more likely you are to dislocate your shoulder,” Sauerbrey said.
But, the injury can result from a fall in an icy parking lot just as easily as on the slopes.
“Any time you fall on an outstretched hand, with the arm partly behind you, it’s possible the shoulder could get pushed out,” Sauerbrey said.
Can other injuries happen?
Yes. When the ball of the arm bone moves out to the side, the muscles and ligaments that help hold the shoulder in place can also tear. The impact of a fall can also result in a broken bone, which is why further evaluation at the emergency department is important.
Does one mean others are more likely?
Yes. “Once the shoulder has come out, then everything changes,” Sauerbrey said. “As soon as you get into that provocative position, it can come out again.”
For some people, dislocations become frequent and can be set off by a simple, quick movement or even while sleeping.
“Every time that shoulder comes out, it’s damaging the joint and it’s also damaging the bone,” Sauerbrey said. Shoulder surgery may be necessary to maintain the long-term health of the joint if dislocations become frequent.
How is it treated?
The first time a shoulder is dislocated, it’s best to rest for a week or two and then do physical therapy to get a range of motion and strength back. With a second dislocation, an MRI will likely be ordered to determine if the ligament is torn or the bone is affected. Most people who have more than one dislocation will need surgery to reattach ligaments.
But after an initial shoulder dislocation, if there are no additional injuries, many people feel fine in a few days.
“As soon as it’s put back into place, a few days later, you can feel fine,” Sauerbrey said. “It’s pretty dramatic.”
Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at firstname.lastname@example.org.
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