SHOULDER INSTABILITY
Shoulder
Dislocation
A shoulder dislocation occurs when the ball comes completely out of the socket. It is one of the most common injuries treated by shoulder specialists and frequently occurs during sports, falls, or traumatic accidents. Proper treatment after the first dislocation is important because it can significantly influence the risk of future instability.
Traumatic Injury
Anterior Dislocation
Future Instability
Prevent Recurrence
What Is A Shoulder Dislocation?
The shoulder is a ball-and-socket joint with more motion than any other joint in the body. That remarkable mobility also makes it the most commonly dislocated major joint.
During a dislocation, the ball of the humerus completely comes out of the socket, often tearing the labrum and stretching or tearing the stabilizing ligaments. In some patients, the injury also causes bone loss or fractures of the glenoid or humeral head.
Dr. Streit's Clinical Perspective
The shoulder rarely dislocates without damaging something. My goal after every dislocation is to determine exactly what was injured—not simply confirm that the shoulder came out of place. That information determines the treatment plan and the risk of future instability.
Common Symptoms
Visible Deformity
The shoulder often appears squared off or visibly out of position.
Severe Pain
Pain begins immediately and is often intense.
Unable To Move The Arm
Most patients cannot comfortably move the shoulder until it is reduced.
Instability
The shoulder feels as though it is slipping or out of place.
Numbness
Temporary numbness around the shoulder can occur because of stretching of the axillary nerve.
Muscle Spasm
The muscles surrounding the shoulder often tighten dramatically after the injury.
What Causes A Shoulder Dislocation?
Sports Injuries
Football, wrestling, hockey, rugby, skiing, and basketball are common causes.
Falls
Falling onto an outstretched arm frequently produces an anterior dislocation.
Motor Vehicle Accidents
High-energy trauma may produce associated fractures and soft tissue injuries.
How Is A Shoulder Dislocation Diagnosed?
Diagnosis begins with a physical examination and X-rays to confirm the direction of the dislocation and identify any associated fractures. Once the shoulder has been reduced, additional imaging such as MRI or CT may be recommended to evaluate the labrum, rotator cuff, glenoid bone loss, or Hill-Sachs lesion.
History
Physical Examination
X-rays
MRI / CT
What Happens After The Shoulder Is Put Back In Place?
After reduction, the next step is determining the likelihood that the shoulder will dislocate again. That risk depends on several factors, including your age, activity level, sport, bone loss, and the specific injuries that occurred during the dislocation.
What I Tell My Patients
"Getting the shoulder back into place is only the beginning. The more important question is why it dislocated, what structures were injured, and what we can do to keep it from happening again."
Will My Shoulder Dislocate Again?
The answer depends largely on who you are.
Young athletes who participate in contact or collision sports have a much higher risk of recurrent instability than older adults who sustain a dislocation after a fall. Because of this, treatment recommendations after a first dislocation are often very different for a 17-year-old football player than for a 70-year-old patient who slipped on ice.
Treatment Options
Immobilization
Short-term sling use allows pain to improve after the injury.
Physical Therapy
Rehabilitation restores motion, strength, and dynamic shoulder stability.
Surgery
Selected patients benefit from early stabilization to reduce the risk of recurrent instability.
Related Resources
Dislocated Your Shoulder?
A comprehensive shoulder evaluation can identify the injuries associated with your dislocation and determine whether rehabilitation or early stabilization surgery offers the best chance of preventing future instability.
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