Dislocated shoulder

In cases where you have a complete dislocation, it is possible that you’ll be able to identify a dislocated shoulder by looking in the mirror. Your shoulder may be visibly out of place with a lump or bulge. This is particularly the case when your shoulder slips forward. This is known as an anterior shoulder dislocation – the most common form of shoulder dislocation. Your shoulder can also dislocate backwards or downwards (posterior shoulder dislocation).

Other signs that you may have a dislocated shoulder include:

• Inability to move your arm
• Severe pain in your shoulder area (can move up to your neck)
• Your shoulder looks square rather than round
• Swelling and bruising on your shoulder and upper arm
• Numbness and/or weakness in your arm, neck, hand, or fingers
• Muscle spasms in your shoulder

A dislocated shoulder occurs when you experience extreme force against your shoulder that pulls the bones out place, either partially or completely. Acute twisting of your shoulder joint can also cause the ball of your upper arm bone to come out of your shoulder socket. This may happen following a trauma impact of some kind, which could be a result of:

Sports injuries

Shoulder dislocation is common in sports that involve constant contact, such as football, rugby, or hockey. For example, you may fall on your shoulder after being tackled, or after going up for a header. If this fall occurs when you are moving at a high speed, or coming up against serious high-pressure impact with another player, the force on your shoulder can cause the top of your arm bone to come out of your shoulder socket. Along with contact sports, shoulder dislocation may also come in sports that could result in falling, such as downhill skiing or gymnastics.

Falls

You might experience a shoulder dislocation after having a fall. This can happen if your job involves using ladders or other equipment that requires you to climb. If you have limited mobility due to old age, you may also be at greater risk of having a fall, such as tripping over loose carpets or slipping on ice.

Trauma not related to sports

Any hard blow to your shoulder can potentially cause shoulder dislocation. If you are in a car crash, for instance, there is a chance that the severe impact on your shoulder will pop your shoulder joint out of its socket. It may also come as a result of an electric shock or seizure, which can cause powerful muscle spasms that lead to injuries such as shoulder dislocation.

If you have loose joints (known as joint hypermobility) that mean your shoulder is more flexible than usual, you may also be at a greater risk of having a dislocated shoulder.

The treatment your consultant chooses for you will be based on a range of factors, such as:

• The severity of your shoulder dislocation
• Your age, overall health, and medical history
• Your tolerance of specific medicines and/or therapies

Once your consultant has confirmed that you have a dislocated shoulder, they will most likely begin by recommending a closed reduction procedure, which is generally given immediately after the dislocation occurs.

Closed reduction

Depending on the amount of pain and/or swelling you're experiencing, your consultant will provide you with a local anaesthetic (numbs the shoulder area) or general anaesthetic (puts you to sleep) to ease your discomfort, ahead of using careful positioning techniques that move your arm bone back into your shoulder socket without surgery.

The specific manoeuvre will be based on the nature of your shoulder dislocation. A common one involves you lying on your back and your consultant holding your forearm and lifting it vertically, applying gentle traction that allows your upper arm joint to be slightly rotated and slotted back into your shoulder socket. Your closed reduction may take around 30 minutes to complete, and your pain should stop almost immediately.

If your shoulder dislocation occurred more than three weeks ago, closed reduction is unlikely to be effective and you may need surgery. So, be sure to arrange an appointment with your consultant as soon as possible after your shoulder injury.

Immobilisation

To keep your shoulder in the right place and ensure that it heals properly after closed reduction, along with minimising any discomfort, your consultant will then immobilise your shoulder. This will involve placing your arm into a splint or sling, which you'll need to keep on for about a week. Be sure to ice the affected area three or four times a day.

Rehabilitation

Once your splint or sling is no longer needed, your consultant will draw up a rehabilitation plan that is tailored to you. You will be given a series of exercises, starting off with gentle movements that encourage muscle toning, ahead of moving into exercises designed to restore your shoulder's range of motion and strengthen your muscles, followed eventually by weight training. This rehabilitation stage is important due to how it helps to prevent you from experiencing another shoulder dislocation in the future.

If your shoulder has been dislocated on more than one occasion, or your tendons and/or ligaments have been torn or stretched due to the force that caused your shoulder dislocation, your consultant may recommend surgery. This often happens with athletes, and can reduce the risk of them experiencing the same issue in the future. In rare cases, damaged nerves and/or blood vessels might need surgery.

The exact surgical procedure you receive depends on your particular condition, but in most instances, your surgeon will recommend arthroscopic surgery.

What happens during arthroscopic surgery for dislocated shoulder?

The procedure lasts around an hour, and is performed under general anaesthetic, which means you'll be asleep for the entire operation and won't feel any pain. It is an outpatient procedure, so you'll be able to go home on the same day.

Your surgeon will make a small incision at the site of your shoulder joint. Using a slim, pencil-sized instrument that has a video camera and light attached to the end (known as an arthroscope), they can look into your joint and receive live real-time footage of the inside of your shoulder. This allows your surgeon to have a clear view of your bones, tendons, ligaments, and labrum (fibrous tissue that keeps the top of your upper arm bone in place).

After looking inside your shoulder joint and seeing the areas that need treatment (a torn labrum, loose tendons, etc.), they will then make another separate small incision and use tiny specialist surgical instruments to repair and/or tighten the parts of your shoulder joint that have been damaged or come loose due to your shoulder dislocation.

Recovering from arthroscopic surgery for dislocated shoulder

You will be provided with pain medication for the first two weeks, along with a sling that you'll need to wear for four to six weeks so that your tissues heal. Your consultant will book in another appointment with you two weeks after the surgery to check on your healing process. At the six-week mark, you'll be able to begin your rehabilitation programme, which generally lasts for between three and six months, during which you should regain full range of motion and strength in your shoulder.

At your initial consultation, your consultant will start by asking about your dislocated shoulder. They will gather information about how you injured your shoulder, how long ago the injury occurred, whether it has happened before, and your symptoms. This helps them know how exactly you dislocated your shoulder and understand the best way to treat your specific injury.

Your consultant will then conduct a physical examination, which involves them looking at your shoulder to see if your joint is out of place. They will also check how well you can move your shoulder and notice when and where the pain shows up for you as you go through these motion tests. Nerve tests may also be done to check if there's an associated injury to one of your arteries.

After completing this physical examination and getting a detailed history of your shoulder dislocation, the next step will be to get an X-ray of your shoulder. This test helps your consultant see if there is any additional injury to the shoulder joint, such as inflamed cartilage or damaged ligaments, along with potential broken bones, which can occur alongside dislocated shoulders.

If your consultant finds that there has been additional damage to the surrounding tendons, ligaments, or nerves in your shoulder joint, or if your dislocated shoulder is severe and/or occurred more than a few weeks ago, they may recommend surgery. However, in cases where your dislocated shoulder happened recently and there isn't any additional damage to your tissues, they will most likely suggest a closed reduction, which allows them to put your upper arm bone back into your shoulder socket without surgery.

When you choose to go private with Circle Health Group, you can expect:

• Flexible appointment times and locations to suit your schedule
• The freedom to choose which hospital and consultant best matches your needs
• Personalised, consultant-led treatment plans adapted to your preferences and requirements
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private cosy ensuite rooms as standards and delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to learn more about dislocated shoulder, book your appointment online today or call a member of our team directly on 0141 300 5009.

Content reviewed by Circle in-house team in December 2022. Next review due December 2025.

1. Dislocated shoulder, OrthoInfo
2. Dislocated shoulder, Mayo Clinic
3. Shoulder dislocation, John Hopkins Medicine
4. Nonsurgical Treatment for Shoulder Dislocation, NYU Langone Health