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This article was co-written by Jonas DeMuro, MD. Dr. DeMuro is a licensed pediatric health surgeon in New York. He received his MD from Stony Brook University School of Medicine in 1996. He completed his study in Surgical Urgent Care at the North Shore-Long Island Jewish Health System and served as a member. from the American College of Surgeons (ACS).
There are 9 references cited in this article that you can view at the bottom of the page.
This article has been viewed 1,900 times.
Dislocation, especially the shoulder joint, is a painful injury and temporarily disables mobility – the shoulder joint is virtually immobile until it is corrected. The shoulder joint is particularly prone to dislocation because it is the most movable joint in the body, and people often fall on their hands when falling, causing the shoulder joint to be placed in an unfavorable position. [1] X The best source of research is always to have the shoulder chiropractor medical professional, although in an emergency you can try to handle it yourself. Shoulder dislocation, if not corrected in time, can lead to complications requiring surgical intervention.
Steps
Handling when dislocated shoulder
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Recognize the symptoms. Shoulder dislocation usually occurs when you fall and rest on your arm or when the shoulder is impacted from behind. Trauma that causes sudden and severe pain after feeling and/or hearing a “crack”. Shoulders become deformed or out of position markedly, swelling and bruising very quickly. [2] X Trusted Source Mayo Clinic Go to source The shoulder will not be able to move until it has been corrected.
- The dislocated shoulder will sag lower than the other shoulder, and there is often an indentation in the deltoid (shoulder muscle).
- A shoulder dislocation can also cause numbness, tingling, and/or weakness in the arm and hand. If the blood vessels are damaged, the forearm and hand on the injured shoulder will become cold and blue.
- About 25% of shoulder dislocations are accompanied by a fracture of the arm or shoulder bone. [3] X Research Sources
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Keep your arms steady. While you wait for medical attention, it is important that you do not move (or try to move) your dislocated shoulder as this could make the condition worse. Shoulder dislocations can be accompanied by fractures, nerve damage or tearing blood vessels, so any movement carries the risk of serious consequences. Instead, bend your elbows, wrap your forearms in front of your stomach, and hold them in place with a sling. [4] X Trusted Source Mayo Clinic Go to Source
- If you don’t have a ready-made sling, you can make your own with a pillowcase or fabric item. Strap the arm under the elbow/forearm and tie the ends of the fabric around the neck. A sling will help stabilize and protect the shoulder from further injury and will often provide significant pain relief.
- About 95% of shoulder dislocations are anterior dislocation, i.e. the humerus is pushed forward in front of the scapula. [5] X Research Sources
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Apply ice. Apply ice or cold objects to the dislocated shoulder as soon as possible to fight inflammation and relieve pain. [6] X Trusted Source Mayo Clinic Going to the source Ice causes small blood vessels to constrict (narrow), which in turn helps reduce blood flow to the injured area. Apply ice cubes to your shoulder for 15-20 minutes (or until you feel numb) about every hour.
- Always wrap ice in a thin cloth, towel or plastic wrap before applying it to bare skin – it will help prevent frostbite or skin irritation.
- If you don’t have crushed ice or ice cubes, you can use a bag of frozen vegetables or a frozen gel pack.
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Take pain relievers. Once the dislocated shoulder has been immobilized and cold, you can take an over-the-counter pain reliever to fight inflammation and relieve pain. The pain of a shoulder dislocation is often described as almost unbearable due to stretching and/or tearing of ligaments, tendons and muscles, in addition to possible fractures and fractures of cartilage. Ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn) are usually the best options because of their strong anti-inflammatory properties, although acetaminophen (Tylep) can also be helpful in pain control. [7] X Research Sources
- For shoulder dislocations with internal bleeding (a lot of bruising), you need to avoid ibuprofen and naproxen because these drugs often “thin the blood” and reduce the ability of the blood to clot.
- Muscle relaxants may also be needed if the muscles around the dislocated shoulder joint are contracted. However, you absolutely must not mix these drugs at the same time – only take one of the two.
Shoulder alignment in emergency situations
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Shoulder articulation only in emergency situations. In most cases, it’s best and safest to wait for help from a medical professional, but sometimes your condition doesn’t allow it. If you are located far away and cannot access medical care (camping, hiking, traveling abroad), the risks of shoulder arthroplasty may outweigh the benefits of immediate pain relief. and arm/shoulder immobilization.
- As a general rule, if you can access medical help within 12 hours, wait patiently and try to ease the pain with ice, pain medication, and a sling. If the waiting time is longer, especially if you need to immobilize your shoulder to get to the hospital, you may want to consider a shoulder brace.
- Complications mainly associated with shoulder manipulation include: more torn muscles, ligaments and tendons, nerve and blood vessel damage; life-threatening bleeding, pain so severe that you lose consciousness. [8] X Trusted Source Mayo Clinic Go to Source
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Find help in an emergency situation. If you are forced to consider a shoulder reposition in an emergency, understand that repositioning without support is nearly impossible. So ask someone to help or help others in an emergency situation. Many people may hesitate because they don’t want to cause you more pain or injury, so you need to reassure them that they won’t be held responsible.
- If you want to help someone with a shoulder reshaping, make sure they agree and make it clear that you have no medical expertise (if needed). You probably don’t want to be sued for trying to help and making things worse. [9] X Research Source
- If you have a phone and can make calls, try contacting emergency services for assistance and advice. Even if paramedics can’t get there right away, they can still give you helpful instructions.
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Lie on your back and extend your arms. Perhaps the easiest way to reposition the shoulder without expertise is to lie on your back and extend the injured arm away from you at a 90-degree angle. You will then have someone grasp your hand or wrist and pull the arm out slowly (but firmly). The support person may have to put their feet close to your upper body for extra leverage. Pulling the arm at this angle will allow the head of the humerus to slide below the shoulder blade and into its place with relative ease. [10] X Research Source
- Remember to pull slowly and evenly (don’t pull quickly and jerkily) away from your torso until your shoulders are engaged. If successful, you should hear a click and feel your shoulders return to their original position.
- As soon as the shoulder is realigned, the level of pain associated with the injury is greatly reduced. However, at this point the shoulders are still not stable and you need to use a shoulder strap and immobilize the arm if possible.
Seek medical attention
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See your doctor as soon as possible. Getting to your doctor (or medical professional) early is important when dealing with a dislocated shoulder. The reason is that when the muscles, tendons and ligaments around the injured shoulder have tightened, the humeral head will be very difficult to straighten without surgical intervention. Most doctors will order an x-ray of the shoulder before taking any action to rule out a fracture. [11] X Research Source
- If nothing is severely broken or torn, the doctor may perform a closed shoulder maneuver. You may need to use a sedative, a strong muscle relaxer, or an anesthetic before the procedure, because the procedure can be very painful.
- A popular closed manipulation of the shoulder joint is the Hennepin maneuver, which uses the external rotation technique of the shoulder. [12] X Source of Study This test is done when you lie on your back, your doctor pulls your elbows at a 90-degree angle and slowly rotates your shoulders outward (external rotation technique). A slight push in this pose is usually enough to realign the shoulder joint.
- There are a number of other techniques that doctors can use, depending on what they are comfortable with.
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Prepare for the possibility of surgery. If your shoulder is frequently dislocated (due to bone deformity or ligament stretching), or if there is a broken bone or torn nerves and/or blood vessels, you may need surgery to repair the damage and correct it. shoulder joint by open surgery. [13] X Research Sources Surgery is sometimes the best option, as it can repair internal damage and stabilize joints, and this greatly reduces the risk of future dislocations.
- There are many different surgical approaches, and which one to use depends on the extent of the injury and the patient’s activity/lifestyle level.
- Some studies suggest that “open surgery” may be the best therapy for adults under 30 with high activity levels due to its low recurrence rate and improved quality of life. [14] X Research Source
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Shoulder rehabilitation. Whether your shoulder is corrected with closed manipulation or open surgery, you will be introduced to physical therapy and strengthening of the shoulder joint. [15] X Resources A physical therapist, chiropractor, and/or sports therapist can teach you stretches to restore range of motion in your shoulder and other muscles. Exercise strengthens and tightens joints to reduce the risk of future dislocations.
- The recovery time before physical therapy is about 2-4 weeks. Wearing a sling, applying ice, and taking pain medication are treatments during the recovery period. [16] X Research Source
- The total time of treatment and rehabilitation after shoulder dislocation lasts about 3-6 months, depending on the severity of the injury and whether the patient is an athlete or not. [17] X Research Source[18] X Research Source
Advice
- Once the pain/inflammation has subsided for a few days, you can apply moist heat to your shoulder to relax tense and sore muscles. Herb bags that can be heated in the microwave also work well. However, you should limit the heat to about 15-20 minutes at a time.
- Once you’ve dislocated your shoulder once, you’re at increased risk for future dislocations, especially if you play contact sports.
- Correction of the shoulder after an accident occurs as soon as possible, because the longer it is left, the more difficult it is to correct.
- A shoulder dislocation is different from a cochlear dislocation. A sacroiliac dislocation is a condition in which the ligaments that connect the joint that are responsible for keeping the collarbone in front of the shoulder blade – the arm joint – are not dislocated.
Warning
- After correcting the dislocated shoulder, you need to check the pulse in the injured limb below the dislocation site. The pulse in the injured arm should be the same as that of the other arm (uninjured limb). If your pulse is slow or you can’t see it, you need to go to the emergency room quickly, because cells start to die very quickly, which can lead to loss of the arm.
X
This article was co-written by Jonas DeMuro, MD. Dr. DeMuro is a licensed pediatric health surgeon in New York. He received his MD from Stony Brook University School of Medicine in 1996. He completed his study in Surgical Urgent Care at the North Shore-Long Island Jewish Health System and served as a member. from the American College of Surgeons (ACS).
There are 9 references cited in this article that you can view at the bottom of the page.
This article has been viewed 1,900 times.
Dislocation, especially the shoulder joint, is a painful injury and temporarily disables mobility – the shoulder joint is virtually immobile until it is corrected. The shoulder joint is particularly prone to dislocation because it is the most movable joint in the body, and people often fall on their hands when falling, causing the shoulder joint to be placed in an unfavorable position. [1] X The best source of research is always to have the shoulder chiropractor medical professional, although in an emergency you can try to handle it yourself. Shoulder dislocation, if not corrected in time, can lead to complications requiring surgical intervention.
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