If you have acute dislocation of the shoulder you’ll feel such a severe pain in your arm that you probably won’t want to let anyone touch it. Sometimes there’s a swelling in front of the shoulder, with a corresponding ache and a feeling of looseness. Sportsmen with traumatic dislocations often think they have a ‘dead arm’.
As the shoulder has a huge range of motion it is quite unstable and relies on the surrounding muscles and ligaments to stop it dislocating. If these muscles or ligaments become damaged, the shoulder can become unstable in any direction.
Dislocation often happens after a fall when the arm is twisted up and away from the body. The tissues at the front of the shoulder, which is known as the ‘labrum’, can be damaged, teasing them away from their attachment. Acute dislocation is normally quite easy to diagnose. A doctor may use an X-ray, MRI or CAT scan to examine the dislocation.
The first priority is to replace the shoulder into its joint. There will probably be people who know how to do this standing on the side of any sports field. If not, you will be taken to hospital where you’ll receive painkillers and muscle relaxant. Your shoulder will then be manipulated back into place.
An X-ray or simply the instant relief of pain will show that your shoulder is back to normal. Sometimes you might need a full anaesthetic to move the shoulder back into place. Once the shoulder is back in its joint, you’ll need to wear a sling for three weeks or so, after which you’ll have physiotherapy to strengthen the muscles.
After a dislocation there is a chance that the same thing may happen again, particularly if you’re young or you play contact sports. If this is the case you may have to wear an external brace for three weeks rather than a sling, as this could reduce the risk of another dislocation. In severe cases a specialist shoulder surgeon may have to operate to stabilise your shoulder.