Shoulder Dislocations

Dislocations of the shoulder joint are common in sports(part of the scapula or shoulder blade) which acts to
involving contact elements such as Rugby andincrease the congruency of the joint by effectively
American football. They also occur frequently fromdeepening the socket. Damage to other soft tissues
falls, usually onto an outstretched arm. The mostsuch as rotator cuff tendons, nerves and blood
common position for a shoulder dislocation is with thevessels are also common.
arm out to the side and rotated outwards. This resultsFor this reason it is important that a dislocated shoulder
in the most common form of shoulder dislocations, anis never put back in place by someone who is not
anterior dislocation, which make up to 95% of alltrained to do so. Usually, an X-ray or MRI will be taken
dislocations. This is where the head of the humerusbefore the shoulder is reduced to check for any
(top of the arm bone) moves forwards of the shoulderassociated damage. After this, depending on the
joint. Dislocations can also be posterior, inferior, superiordirection of dislocation, a manoeuvre will be performed
or intra-throacic.to allow the humerus to move back into position. The
The reason shoulder dislocations are so common isarm will then be immobilised in a sling for a week or
the level of mobility and hence instability, of themore.
shoulder joint as a whole. The shoulder has the largestAfter a dislocation the chances of the same shoulder
range of motion of any joint in the body, but thedislocating again are higher. This is due to laxity in the
congruency of the articulating bones (humerus andjoint capsule and ligaments surrounding the joint after
scapula) is very poor. The joint therefore relies on thethey were stretched during the first injury. Any
support of the surrounding soft tissues - the jointassociated injuries also make repeat dislocations more
capsule, labrum, ligaments and muscles.likely.
Shoulder dislocations are often considered to be fairlyIn order to prevent recurrent dislocations, a period of
minor injuries, however the damage that can beextensive rehabilitation is required. This should aim to
associated with a dislocation can be very severe. Thestrengthen the muscles surrounding the shoulder joint,
most common damage is to the glenoid labrum. This isimprove proprioception (the sense of the joints
a ring of cartilage surrounding the socket of the jointposition), and restore full range of motion.