Saturday, 1 February 2014

Shoulder dislocations

Shoulder joint , which is a ball and socket joint, is the most mobile joint in our body, which means it moves well in all directions. However, this occurs at a cost-it is susceptible to become unstable.
The shoulder joint is made stable by a few anatomic structures including a bumper which goes all the way around the socket- the labrum, the ligaments-which are cord like structures and muscles around the shoulder. Anything that interferes with the normal functioning of these structures or anything that damages these structures can result in shoulder instability.

Shoulder dislocation is said to happen when the ball comes out of the socket completely, a subluxation is said to happen when it only comes out partially.

Injuries to the tissue rim surrounding the shoulder socket can occur from acute trauma or repetitive shoulder motion. Examples of traumatic injury include:

Falling on an outstretched arm
A direct blow to the shoulder
A sudden pull, such as when trying to lift a heavy object
A violent overhead reach, such as when trying to stop a fall or slide

Throwing athletes or weightlifters can experience glenoid labrum tears as a result of repetitive shoulder motion.

Dislocation is characterised by severe pain, muscle spasm, obvious deformity of the shoulder and sometimes numbness and a sensation of the whole arm feeling 'dead'. 
Once, the shoulder dislocation happens, the ball needs to be pulled back into the socket at the earliest. Occasionally it slips back on its own, more frequently the shoulder joint needs to be relocated manually by the doctor.

In most cases some pain may persist for a couple of weeks, and in some it can be accompanied by an injury to a nerve, which is usually temporary. 

This episode of dislocation can result in long term problems of instability and recurrent dislocation especially so, if a person sustains his/her first dislocation at a very young age, i.e in their teens or twenties.
Although the symptoms can be kept under control to some extent, recurrent dislocations or instability symptoms may require surgical intervention, to repair the damaged structures.

Futher information can be obtained from

or write to me at,

Dr Vinod Kumar
Consultant Orthopaedic Surgeon
Aster Medcity, Cochin.