Dislocated Shoulder: Risks of Movement, What to Do, and Professional Treatment

Can you move a dislocated shoulder?

Attempting to move or "reduce" a dislocated shoulder yourself is strongly discouraged and can lead to severe, irreversible damage. Immediate medical attention is crucial for safe and proper treatment.

Understanding Shoulder Dislocation

The shoulder is the body's most mobile joint, a ball-and-socket articulation formed by the head of the humerus (upper arm bone) fitting into the glenoid fossa (a shallow socket) of the scapula (shoulder blade). This incredible mobility, however, comes at the cost of stability, making the shoulder highly susceptible to dislocation.

What Happens During a Dislocation: A shoulder dislocation occurs when the head of the humerus is forcibly displaced from the glenoid fossa. This traumatic event typically involves a tearing or stretching of the ligaments, joint capsule, and sometimes the surrounding muscles (like the rotator cuff), which normally hold the joint together. The severity of the injury depends on the force involved and the direction of the dislocation.

Types of Dislocations:

• Anterior Dislocation: The most common type, where the humerus moves forward and downward.
• Posterior Dislocation: Less common, often resulting from seizures or electric shocks, where the humerus moves backward.
• Inferior Dislocation: The least common, where the humerus moves directly downward.

The Immediate Aftermath: Signs and Symptoms

Recognizing a dislocated shoulder is often straightforward due to the dramatic nature of the injury. Key signs and symptoms include:

• Severe Pain: Intense, immediate pain that often worsens with any attempt to move the arm.
• Visible Deformity: The shoulder may appear visibly out of place, with a prominent bulge anteriorly (front) or posteriorly (back), and a flattened appearance of the deltoid muscle.
• Inability to Move: The affected arm will likely be immobilized by pain and muscle spasm, making any movement excruciating or impossible.
• Numbness or Tingling: Damage or compression to nerves (such as the axillary nerve) can cause numbness, tingling, or weakness in the arm or hand.
• Swelling and Bruising: These may develop rapidly due to tissue damage and internal bleeding.

The Critical Question: Should You Attempt to Move or Reduce a Dislocated Shoulder?

The unequivocal answer from exercise science and medical professionals is NO. Under no circumstances should an untrained individual attempt to move, pull, or "pop" a dislocated shoulder back into place. This applies to self-reduction and attempts by well-meaning but unqualified bystanders.

Why Not? The Risks Are Significant:

• Further Injury to Soft Tissues: The joint capsule, ligaments, and tendons are already stretched or torn. Improper manipulation can exacerbate these tears, leading to more extensive damage and a longer, more complicated recovery.
• Nerve Damage: The shoulder region is rich with vital nerves (e.g., axillary, musculocutaneous, radial, ulnar, median nerves) that can be stretched, compressed, or even severed by an inexpert attempt at reduction. This can result in permanent numbness, weakness, or paralysis.
• Blood Vessel Damage: Important arteries and veins run near the shoulder joint. Forceful, unguided movements could rupture these vessels, leading to severe internal bleeding and potential limb-threatening complications.
• Fractures: A dislocated shoulder can sometimes be accompanied by a fracture of the humerus or glenoid. Attempting to reduce the shoulder without knowing if a fracture exists can turn a simple dislocation into a complex fracture-dislocation, requiring more invasive treatment.
• Increased Pain and Muscle Spasm: Amateur attempts at reduction are almost always excruciatingly painful, leading to increased muscle spasm around the joint, which makes subsequent medical reduction more difficult.
• Incomplete Reduction: Even if the humerus appears to be back in place, it might not be properly seated in the glenoid, leading to ongoing instability and potential for repeated dislocation.

What to Do Immediately After a Shoulder Dislocation

If you suspect a shoulder dislocation, your immediate actions are critical for minimizing harm and facilitating professional treatment:

• Seek Immediate Medical Attention: Call emergency services (e.g., 911 in the U.S., 999 in the UK) or transport the individual to the nearest emergency room. This is not an injury to "wait and see" about.
• Immobilize the Arm: Gently support the injured arm in the most comfortable position possible. A sling, a pillow, or even binding the arm to the body with clothing can help prevent further movement. Do not force the arm into any position.
• Apply Ice: Place ice packs (wrapped in a cloth to protect the skin) on the affected shoulder to help reduce swelling and pain.
• Avoid Food and Drink: If medical reduction with sedation is likely, avoiding food and drink prevents complications related to anesthesia.
• Remain Calm: Reassure the injured person and keep them as comfortable as possible while waiting for medical help.

The Medical Professional's Role: Reduction and Beyond

Upon arrival at a medical facility, the process typically involves:

• Diagnosis: A physical examination will confirm the dislocation, and X-rays will be taken to rule out any accompanying fractures and confirm the direction of the dislocation.
• Reduction Techniques: Under appropriate pain management and often sedation, a trained medical professional (doctor, orthopedic surgeon) will perform specific maneuvers to gently guide the humerus back into the glenoid fossa. There are various techniques (e.g., traction-countertraction, external rotation, Stimson technique), chosen based on the type of dislocation and the patient's condition.
• Post-Reduction Care: After successful reduction, another X-ray is often taken to confirm proper placement. The arm will then be immobilized in a sling for a period, typically 3-6 weeks, to allow damaged tissues to heal. Pain management and RICE (Rest, Ice, Compression, Elevation) protocols will be prescribed.

Long-Term Considerations and Rehabilitation

A dislocated shoulder requires a comprehensive rehabilitation program to restore full function and minimize the risk of recurrence.

• Importance of Physical Therapy: Once initial healing has occurred, a physical therapist will guide you through a structured program. This typically includes:
  • Restoring Range of Motion: Gentle exercises to regain flexibility.
  • Strengthening: Focusing on the rotator cuff muscles, deltoid, and scapular stabilizers to enhance joint stability.
  • Proprioception Training: Exercises to improve the body's sense of joint position, which is crucial for preventing future dislocations.
• Risk of Recurrence: Younger individuals, especially those under 30, have a significantly higher risk of recurrent dislocations. Engaging in contact sports or activities with overhead movements can further increase this risk.
• Surgical Intervention: In cases of recurrent dislocations, significant soft tissue damage (e.g., Bankart lesion, Hill-Sachs lesion), or persistent instability, surgical repair may be recommended to stabilize the joint.
• Return to Activity: A gradual return to sports and strenuous activities is essential, guided by your physical therapist and doctor. Premature return can lead to re-injury.

Conclusion: Prioritizing Safety and Expert Care

While the urge to "fix" an obvious injury like a dislocated shoulder can be strong, it is paramount to resist this impulse. The intricate anatomy of the shoulder and the potential for severe, permanent damage from improper manipulation demand that this injury be handled exclusively by qualified medical professionals. Your role, or the role of a fitness professional witnessing such an event, is to ensure the individual receives immediate, expert medical attention to guarantee the safest and most effective recovery.