Shoulder Dislocation: How It Happens in Real Life

Only a doctor should “pop” a shoulder back in place

shoulder pain illustration

Treating a dislocated shoulder always looks so easy in the movies and on TV. In real life, you should seek medical attention right away.

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We’ve all seen those dramatic scenes when an actor just “pops” a dislocated shoulder back into place, then is ready to jump right back into the action.

In the real world, this injury is more serious and not quite so quick and easy to treat.

In fact, dislocations, especially in young people, are not something that typically get better on their own. That’s why it’s important to follow up with an orthopaedic surgeon.

Caused by torque, not impact

A shoulder dislocation happens when the upper arm bone (the humerus) comes out of the socket of the shoulder joint.

The shoulder is our body’s most mobile joint, making it highly functional but also easier to injure than most other joints.

The way shoulder dislocations happen is by what doctors call abduction and external rotation of the arm. This means that the arm is outstretched and then turned, popping the humerus out of the socket.

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We see these kinds of injuries most commonly in sports like football, wrestling and skiing. For example, a football player may extend his arm for a block while an opposing player puts torque on that arm.

It isn’t the impact that causes shoulder dislocations — it’s a twisting motion on an outstretched arm.

How to know if it’s dislocated

If your shoulder is truly dislocated, you’ll know.

You’ll experience severe pain and a feeling of instability in the joint. Your arm may appear to be out of position. You may experience numbness or swelling in your arm. Even if you try to move it, it won’t happen.

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What to do after a dislocation

No matter how many times you have seen those action movies, don’t attempt to “pop” your shoulder or someone else’s back into place on your own. That’s something that should only be done in an emergency room.

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Until you can get a doctor’s help, keep the arm in the same position and apply ice to help with any swelling.

After a doctor puts the bone back into the socket, you’ll feel some immediate relief. But your shoulder may still be sore and swollen for a while. Your doctor will likely give you a sling or brace to wear, and advise you to rest and ice the joint.

Exercises for rehab

Unfortunately, you may be more susceptible to shoulder dislocations in the future because of the way the joint’s ligaments have been stretched.

That’s why doctors often recommend a rehabilitation program, once the pain and swelling are under control. Exercises are designed to strengthen the ligaments and muscles to help prevent re-injury.

 

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Joseph Scarcella, MD

Joseph Scarcella, MD, Orthopaedic Surgery, Cleveland Clinic, has been in practice for more than 20 years in southwest Cleveland hospitals.
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