What Is a Dislocated Shoulder?
Shoulder instability occurs when your shoulder joint (ball and socket) has lost is normal alignment (ball resting symmetrically in the socket), which causes your arm to lose its support. The most common type of shoulder instability is shoulder dislocation with the ball coming out of the socket in the forward direction.
Once your shoulder has dislocated, the risk of it happening again is greater. When your shoulder is loose and slips out of place repeatedly, it’s called chronic or recurrent shoulder instability.
Why Choose University of Utah ǿմý?
Each physician at the University of Utah Orthopaedic Center specializes in a specific area of treatment to give you the best care for your injury. We treat people and athletes of all types, from hobby enthusiasts to elite professional players. Our physicians will help you choose from a wide range of surgical and non-surgical treatments suited for your individual needs and lifestyle.
Shoulder Dislocation Symptoms vs. Shoulder Instability Symptoms
The most common signs of shoulder dislocation are pain and shoulder joint instability (arm bone is not connected to the shoulder socket). You may also experience:
- swelling,
- numbness, or
- bruising,
How Painful Is a Dislocated Shoulder?
You may experience moderate to severe discomfort when your shoulder becomes dislocated. Pain is common during and immediately following dislocation. Recurrent instability and dislocations may be less painful. Your physician will recommend appropriate pain management medication depending on your level of discomfort.
Symptoms of Recurrent Dislocation or Instability
Some common symptoms of chronic shoulder instability include:
- pain,
- repeated dislocations, and
- a persistent sensation of the shoulder feeling loose, slipping in and out of the joint, or just hanging there.
Shoulder Dislocation Types
Our orthopedic specilaists treat the following types of shoulder dislocations:
- Anterior — The dislocation is located on a forward plane, which could occur while throwing a baseball.
- Posterior — This dislocation is located on an axial plane when your arm goes across your body.
- Shoulder Subluxation — This is a partial dislocation, which means your shoulder only partially moved out of its socket.
- Labral Tear — This is a type of shoulder instability that happens when the labrum (cartilage rim) around your shoulder is torn or peeled away from the socket.
Shoulder Dislocation Causes
Dislocations are often caused by sports injuries, trauma (such as a fall or car accident), or overuse.
Some risk factors for shoulder dislocation or shoulder instability include:
- Type and level of activity — Contact sports (such as football) carry an increased risk for injury.
- Age — Younger patients are more prone to getting loose or relaxed joints.
- Genetics — Some people with shoulder instability have never had a dislocated shoulder. Ligaments may be naturally more loose due to genetic factors or collagen tissue disorders such as Marfan’s syndrome
- Hyperlaxity —This medical condition causes ligaments surrounding your joints to bend and stretch more than normal. People with this condition tend to have a wider range of movement or appear “double-jointed.”
- Previous shoulder dislocation or shoulder surgery — If your shoulder has previously dislocated or you’ve undergone surgery to treat shoulder pain, you may be at higher risk for recurrent instability.
Find a Shoulder Specialist
When to Seek Treatment
Shoulder dislocations require immediate care. Visit an emergency care department right away.
Our Orthopaedic Injury Clinic does not treat emergency full dislocation cases. If you are unsure about the extent of your dislocation, please visit our clinic. Our orthopedic specialists will quickly assess your condition and determine the next steps in your care.
Schedule a visit with our clinic if:
- your pain lasts more than one to two weeks.
- you suffer from frequent shoulder subluxation (shoulder joint moves partially in and out of your socket) that lasts more than four to six weeks.
Shoulder Instability & Dislocation Diagnosis
Shoulder instability and shoulder dislocations are diagnosed through a physical exam and medical imaging. During your exam, our orthopedic specialist will gently move your arm to determine the type and extent of your dislocation or instability. We will ask about the history of your instability, including any physical events (sports, accidents, or trauma), that may have caused or contributed to the instability.
Shoulder Dislocation & Instability Treatments
First-time shoulder dislocation is immediately treated in an emergency department by placing the ball of the upper arm back into the socket. You will require oral or intravenous sedation to make the procedure more comfortable. After this, your arm will be in a sling for two to three weeks.
Your doctor will also recommend:
- applying an ice pack several times a day to reduce swelling and inflammation,
- taking over-the-counter pain relief medications as needed,
- beginning a physical therapy regimen to rehabilitate the shoulder joint and restore range of motion, and
- modifying or avoiding activities that cause shoulder strain.
Recovery may take four to six weeks depending on the severity of your dislocation.
Shoulder Instability Surgery
If instability recurs (repeatedly occurs) or does not improve with physical therapy or other treatments, your doctor may recommend surgery to reduce pain, repair damage, and prevent recurrent instability in the future.
Different surgical options are available depending on your needs and specific type of instability.
Labrum Repair
Many patients can be treated with arthroscopy for recurrent shoulder instability. This surgery takes about one and a half hours to complete. It is performed using small instruments and cameras, which minimize damage and may improve recovery time.
Small anchors are inserted into the edge of the shoulder socket to help reattach and repair torn cartilage (labrum) and restore stability. This attachment allows the shoulder to remain stable in the joint when you move the shoulder in many different directions. The goal of labrum repair surgery is to reduce pain in your shoulder by restoring the normal anatomy and function.
Full recovery from your shoulder surgery will take several months to one year, based on the complexity of the surgery and other individual variables.
Bony Instability Procedure
If you have a history of recurrent or severe shoulder instability, open surgery may be recommended. Recurrent instability can cause bone loss, so the goal of surgery is to reattach bone and regain stability by restoring a more normal anatomy.
During this surgery, an incision (cut) is made over the shoulder. Muscles are moved to gain access to the joint capsule, ligaments, and shoulder cartilage (labrum).
Depending on your specific type of injury, your surgeon may insert new bone (from a donor), or bone from the scapula (Latarjet procedure), the hip, or the clavicle. The repair may be completed using screws to fix the bone to the front of the shoulder socket. These procedures typically take two and a half hours to complete.
Recovering From Surgery
Surgery for shoulder instability is an outpatient procedure, meaning most patients will return home the same day as the surgery. During your surgery, your anesthesiologist will place a nerve block to help manage your pain. You may also take oral pain medication as prescribed by your physician.
After surgery, you will be required to use a sling for six weeks to help your joint heal. It’s normal for your shoulder to feel stiff and uncomfortable. You can walk and participate in other low impact activities the day after your surgery. You will start minor physical therapy exercises right away, beginning with hand and elbow movements.
After two weeks, any stitches are removed, and you will begin a more advanced physical therapy regimen involving your upper arm and shoulder.
Six weeks after your surgery, you will be able to lift objects under five pounds and return to most regular movement. As you continue to recover and gain strength, you will add resistance exercises to your physical therapy. Most patients return to preoperative strength and activities after six months.
You will likely see continued improvement in range of motion and strengthening for up to 12 months after surgery.
How to Make an Appointment
To request an appointment with one of our orthopedic specialists, please call 801-587‑7109. Referrals from a primary care doctor or other physician are welcome, but not necessary. Please have your insurance card available to help us determine your coverage and discuss payment options with you.
