How do doctors repair a dislocated shoulder

Shoulder Dislocation: The treatment of a dislocated shoulder

With its ball joint, the shoulder is our most flexible joint in the body. Due to its anatomical structure, however, the shoulder joint is also particularly prone to dislocation - i.e. to dislocating. How is a shoulder dislocation properly treated and in which cases should an operation be performed? Because it can hit anyone: For example, if you fall, or in a sports, bicycle or traffic accident.

Diagnosis of shoulder dislocation - the symptoms of the dislocated shoulder

If the shoulder is dislocated, kick strong pain up and the arm or shoulder joint can no longer be moved properly. Usually a changed shoulder contour is noticeable due to the head of the humerus standing forward. The empty socket can be felt on the back

The shoulder pain often subsides noticeably immediately after the reduction. The head of the humerus is brought back into the joint socket.

Another accompanying symptom can also be a Nerve irritation with a tingling sensation and possible numbness come to the place in question. A bruise and swelling on the shoulder are also possible.

If you suspect that your shoulder is dislocated, only have it corrected by a professionally trained doctor! Otherwise, further injuries to the surrounding structures can occur.

A clear diagnosis of what and how much was really injured is made after the clinical examination and an X-ray check. A magnetic resonance imaging (MRI) examination can provide more information about whether it is also further injuries to the shouldersuch as a rupture of the joint lip.

The anatomy of the shoulder

The shoulder joint is a ball-and-socket joint, consisting of the humerus head and the socket of the shoulder blade. The joint capsule, tendons and muscles as well as a cartilaginous ring (labrum) surrounding the joint socket are responsible for stabilizing the joint.

The spherical joint head of the humerus is relatively large and the socket on the shoulder blade is rather small. In addition, the capsule apparatus is comparatively loose. These factors lead to the Shoulder joint particularly prone to dislocation is.

How does shoulder dislocation and shoulder pain occur?

Young people roll your shoulder most common in sports out. The risk of shoulder dislocation is particularly high in sports such as handball, tennis or skiing. At older people on the other hand is the Risk of falling the most common cause of a dislocated shoulder. Of course, accidents of any kind etc. can lead to it at any age.

If you would like to know how you can prevent falls in your house and apartment, we recommend our free fall prevention checklist.

The shoulder often loosens when trying to catch the arm in the event of a fall or the like. Dislocation often occurs when an opponent comes into contact with the limb, as in handball.

The shoulder joint will suddenly exposed to great pressure and sometimes also rotated unfavorably. The otherwise supporting apparatus of ligaments and muscles can no longer hold the joint and it is dislocated. The humerus head jumps or slips out of the joint socket and the contact between the joint head and the joint socket is completely lost. One then speaks of a complete dislocation. If the contact is only partially broken, it is a partial (partial) dislocation.

In the event of an accident-related - traumatic - dislocation, further injuries such as tears in the joint capsule, the stabilizing ligaments or a tear in the joint lip (labrum gleniodale) can occur. Cartilage, bone and nerve injuries can also occur.

In addition to an accident-related shoulder dislocation, there is also one in some patients Constitutional shoulder instability due to mostly very weak ligaments and very soft connective tissue. With the so-called habitual shoulder dislocation Even minimal strain or everyday movement can lead to dislocation of the shoulder.

It often occurs for the first time in childhood and adolescence. This type of shoulder dislocation is treated differently from and accordingly distinguished from traumatic dislocation.

The therapy of a shoulder dislocation

In the first step, the dislocated shoulder must be adjusted again, i.e. the joint head is brought back into the joint socket as gently as possible by a professionally trained doctor.

Before the procedure, the patient is given pain relievers and, if necessary, muscle relaxants (muscle relaxants). Sometimes the setting is done under a short anesthetic. X-ray control and an MRI in the event of shoulder dislocation provide information about any further injuries and their extent.

This must be done after the reduction Shoulder joint can be immobilized or immobilized to reduce shoulder pain and so the capsular ligament apparatus can heal. Appropriate bandages, orthoses or abduction pillows are prescribed by the doctor for this purpose. You can get these aids from your medical supply retailer.

Since immobilizing the joint can quickly lead to stiffening, intensive physiotherapeutic treatment is advisable in parallel.

If the shoulder is dislocated: surgical or conservative treatment?

Whether the shoulder dislocation is followed by conservative therapy or surgery depends on several factors. Among other things, the patient's age and the consequences of injury are indicative.

If the previous diagnosis shows that important stabilizers in the shoulder have been injured (e.g. tear off of the labrum) or that there are bony injuries, these should be surgically repaired early on in younger, sporty and professionally active patients become. This is the safest way to restore the stability of the shoulder in the long term. Otherwise there is a risk that the shoulder will remain chronically unstable and could dislocate again and again even with everyday movements.

The risk of shoulder osteoarthritis

In addition, the shoulder should be operated on if the bony head of the humerus has become involved, for example if it has collapsed. In this case, the shoulder must be surgically reconstructed so that the joint head and joint socket fit together again as "watertight" as possible. Otherwise it may change over the years a step on one of the articular surfaces at the fracture site which in turn can lead to shoulder osteoarthritis.

If the operation is established as a form of therapy, the first thing is a Jointoscopy (Arthroscopy) performed in order to accurately assess the damage to the joint. The injury diagnosed in this way then determines the further type of operation - which is usually performed arthroscopically.

After the operation, the shoulder should be in the first Weeks can be immobilized by a shoulder orthosis and the arm may only be moved to a limited extent for several weeks.

Older patients over 40 years of age have a much lower risk of the shoulder remaining chronically unstable.

If an injury to the tendons could be ruled out, the joint is often treated conservatively after an initial dislocation: by temporarily immobilizing it with a bandage or orthosis and then training the muscles for stabilization.

A habitual, i.e. recurring shoulder dislocation, after several weeks of immobilization, is initially treated with muscle building training in order to stabilize the joint. If there is still a tendency to dislocate after 12 months of training, an operation may be necessary.

The follow-up treatment of a shoulder dislocation

In both conservative and surgical therapy, physiotherapy treatment should be started as soon as possible after the shoulder has been repositioned to prevent possible stiffening of the shoulder joint.

The intensity of the training varies depending on the type of therapy. While strengthening exercises can be started quickly with conservative treatment, you should only start training for strengthening and coordination of the shoulder girdle muscles after about six weeks after an operation.

In general, the strength of the shoulder can be increased with the following means, among others:

  • Training on devices
  • Free movements with dumbbells
  • Strengthening with elastic bands such as Thera-Band
  • Exercises without aids

Some exercises can also be performed at home after consultation with the physiotherapist. A few examples of suitable exercises without aids can be found in this video.

Conclusion on shoulder dislocation

A dislocated shoulder is a very painful affair, in which the humerus head slips out of the joint socket. The cause of this is usually an accident or a fall, but shoulder dislocation can also occur during sports - especially contact sports such as handball.

In addition to this traumatic dislocation, there is also a habitual dislocation in which the shoulder dislocates due to weak ligaments.

After the shoulder has been adjusted by a trained doctor, it must be immobilized for some time. You can obtain information about suitable bandages from your medical supply store.

After further examinations it will be decided whether conservative or operative therapy will follow. After this, muscle building training should be started in order to stabilize and strengthen the shoulder muscles over the long term so that a renewed dislocation can be prevented.

Do you have any tips on how to strengthen the shoulder? We look forward to your comments.