Dislocated shoulder

If a shoulder dislocates, the upper arm bone (humerus) separates from the shoulder blade (scapula). This injury can cause different symptoms.

We differentiate 3 types of a dislocated shoulder:

  • traumatic shoulder dislocation – caused by an external force
  • habitual shoulder dislocation – without any direct external force, probably genetic
  • recurrent shoulder dislocation – repeating shoulder dislocations

Subject to the direction of the shoulder dislocation, we distinguish as most common types of the dislocated shoulder:

  • anterior shoulder dislocation – forward dislocation
  • posterior shoulder dislocation – backward dislocation
  • inferior shoulder dislocation – downward dislocation

Symptoms dislocated shoulder / shoulder dislocation

A dislocated shoulder can cause severe pain emerging while moving the shoulder or arm, lying upon the shoulder or even without doing anything special. The pain may also induce restricted range of motion. Subject to the type of shoulder dislocation and its severity, the corresponding arm may also stick out or may be twisted. In case joint structures press onto vessels or nerves, even circulatory disorders or paresthesia may occur.

Symptoms of the dislocated shoulder in short:

  • pain while moving, lying on the shoulder or even at rest
  • restricted range of motion
  • arm sticks out or is twisted
  • circulatory disorders and paresthesia

Causes dislocated shoulder / shoulder dislocation

The traumatic shoulder dislocation is caused by an external force. The joint head or ball of the shoulder is separated from its socket. This occurs most often while the arm is stretched out and an external source forces the ball to slide out of its socket using violence. An example would be handball or football players trying to throw the ball while other players try to stop them forcefully. In this case, the arm is fully stretched at the end of the movement and the opponent tries to block the attempt or even twist the arm or move it in another direction. It is of course also possible that a shoulder dislocation takes place during daily activities.

The cause behind the habitual shoulder dislocation is not clarified yet. But it is assumed that there might be a genetic origin. If tendons, joint capsules and ligaments of the shoulder are soft or injury-prone, or if there are certain anatomic variations or degenerations, a shoulder dislocation is more likely to happen.

It does not matter whether it is a traumatic or habitual shoulder dislocation. The risk to dislocate the shoulder again is increased after a previous dislocation. As a consequence, shoulder dislocations may recur why they are called recurrent shoulder dislocations.

Diagnostics dislocated shoulder / shoulder dislocation

The diagnosis dislocated shoulder necessitates a comprehensive orthopedic examination. Often imaging procedures like MRI or X-raying are used to differentiate different diseases that may cause similar or the same symptoms like the impingement syndrome. The best method to differentiate between different injuries is MRI. MRI enables us to visualize very different structures during one examination like muscles, ligaments, tendons, cartilage and bones. If it is necessary, we do also apply a well-tolerated contrast agent to improve the visibility of certain structures.

In some cases, it may be necessary to perform a shoulder arthroscopy, during which an endoscope is inserted through small incisions to visualize the different structures of the shoulder enlarged. If indicated, a subsequent arthroscopic surgery is possible directly after the arthroscopic examination.

All examinations can be carried out at Beta Klinik.

Therapy dislocated shoulder / shoulder dislocation

Normally, the first thing is to return a dislocated shoulder in its normal position (reduction). In this case, the position of arm and shoulder are manually adjusted by a physician until the shoulder has reached its normal position. Subject to the severity of the condition and the patient’s individual sensation, the reduction is done with or without using anesthetics. After the shoulder has been manipulated, its correct position is controlled conducting imaging procedures like X-raying.

It can be necessary to perform arthroscopic surgery (keyhole surgery) in case of serious shoulder dislocations. This holds especially if the shoulder capsule, the glenoid labrum or stabilizing ligaments are severely damaged or torn.

During minimally invasive shoulder arthroscopy, an endoscope is inserted through small skin incisions. With the help of the endoscope, the surgeon is able to see the damaged shoulder structures enlarged at a monitor. In addition to that, surgeons are also able to operate through the endoscope and repair or stabilize shoulder capsule, glenoid labrum or ligaments and to return the shoulder joint to its normal position. The dislocated shoulder and the accompanying pain and restricted range of motion can be treated this way.

After arthroscopic surgery, physiotherapy and rehabilitation should follow in order to improve strength and range of motion.

Read more about minimally invasive shoulder arthroscopy