Shoulder Dislocation

Pathophysiology

Dislocations can be after an injury (e.g rugby tackle or car accident and is usually the first incident) or without trauma (minimal force involved e.g reaching or turning in bed). The ball and socket joint of the shoulder is made up of the upper arm bone (Humerus) and the socket (Glenoid), this joint is supported by many ligaments as well as surrounding muscles and soft tissue. The most common direction of dislocation is forwards (anterior) but can also be backwards (posterior) or inferior (downward).

Symptoms

• After Injury – may be visible deformity, swelling and bruising

• Without Injury – general ache, usually relocates by itself or with minimal help, often hypermobile

Management

• Activity modification

• Ice or heat

• Pain relief

• Physiotherapy

Investigations

• With Injury – X-ray, usually needs relocating in A&E

• Without Injury – normally does not require investigations but physiotherapy can help improve stability and muscular control