Dislocated Shoulder
The upper arm bone has popped out of the shoulder socket
Quick Facts
- Type: Acute orthopedic injury
- Common causes: Falls, sports, accidents
- Main sign: Visibly out-of-place, very painful shoulder
- Treatment: Repositioning, rest, rehabilitation
Overview
A dislocated shoulder occurs when the ball at the top of the upper arm bone (the humerus) comes completely out of the shoulder socket. The shoulder is the body's most mobile joint, which also makes it the most commonly dislocated. Most dislocations push the arm bone forward, out the front of the socket.
A dislocation is painful and usually obvious, and the arm cannot be used normally until the joint is put back in place. After the first dislocation, the shoulder can become more prone to dislocating again, so proper treatment and rehabilitation are important. A related but partial injury is a shoulder dislocation that only partly comes out, known as a subluxation.
Symptoms
A dislocated shoulder typically causes sudden, severe symptoms after an injury.
- Intense shoulder pain
- A visibly deformed or out-of-place shoulder, sometimes with a squared-off look
- Inability to move the arm or use the shoulder
- Swelling and bruising
- Numbness, tingling, or weakness in the arm, hand, or fingers if nerves are affected
A shoulder that looks out of place and cannot be moved needs prompt medical care. Do not try to force it back into place yourself, as this can cause further injury.
Causes
A strong force on the shoulder or an awkward movement can push the arm bone out of its socket.
- Falls: Landing on an outstretched arm or directly on the shoulder.
- Sports injuries: Contact sports and activities such as football, hockey, skiing, and volleyball.
- Accidents: Motor vehicle crashes and other trauma.
- Extreme rotation: Forceful twisting of the arm.
People who have dislocated a shoulder before, or who have naturally loose joints, can dislocate with less force.
Risk Factors
- Participation in contact or high-impact sports
- A previous shoulder dislocation
- Younger age and male sex, which see higher rates of first dislocations
- Naturally loose or hypermobile joints
- Activities with a high fall risk
Diagnosis
A doctor diagnoses a dislocated shoulder from the appearance of the joint and a physical exam, then uses imaging to confirm and check for related injuries.
- X-rays: Confirm the dislocation and reveal any associated fractures.
- Examination of nerves and circulation: Checks for numbness, weakness, or reduced blood flow in the arm.
- MRI: May be used later to assess damage to ligaments, the labrum, or the rotator cuff, especially with repeated dislocations.
Treatment
Treatment focuses on returning the joint to its socket, easing pain, and restoring strength and stability.
- Reduction: A doctor gently maneuvers the arm bone back into the socket, usually with pain relief or sedation. Pain often improves immediately.
- Immobilization: A sling supports the shoulder for a period to allow healing.
- Pain relief and ice: Help with discomfort and swelling.
- Rehabilitation: Physical therapy rebuilds strength, motion, and stability.
- Surgery: May be considered for repeated dislocations or significant damage to the joint structures, such as a torn labrum or rotator cuff, and can often be done using minimally invasive (arthroscopic) techniques.
Following the rehabilitation plan reduces the chance of the shoulder dislocating again. Recovery is usually staged: the joint is first protected and rested, then gentle motion is restored, and finally strengthening exercises rebuild stability before a return to sport or heavy activity. A dislocation can sometimes stretch or tear surrounding ligaments, and in younger, active people the risk of another dislocation is higher, which is why building strength in the muscles around the shoulder is an important part of treatment.
Prevention
- Strengthen the shoulder and surrounding muscles with regular exercise
- Use proper technique and protective gear in sports
- Complete rehabilitation fully after a dislocation before returning to activity
- Take steps to prevent falls, especially in older adults
- Warm up before physical activity
When to See a Doctor
A suspected dislocated shoulder needs prompt medical evaluation. Seek emergency care right away if the shoulder injury is accompanied by:
- Severe pain and obvious deformity
- Numbness, tingling, coldness, or loss of color in the arm or hand
- Inability to move the arm at all
- Signs of a possible fracture
Do not attempt to push the shoulder back into place yourself.
Frequently Asked Questions
What should I do if I think my shoulder is dislocated?
Keep the arm still, support it close to your body, and seek medical care promptly. Do not try to force the shoulder back into place yourself, as this can cause further damage to bones, nerves, or blood vessels. Applying ice can help with pain and swelling on the way.
How is a dislocated shoulder put back in place?
A doctor gently guides the arm bone back into the socket, a procedure called reduction, usually after giving pain relief or sedation. Pain often eases quickly once the joint is back in place. X-rays confirm the position and check for fractures.
How long does a dislocated shoulder take to heal?
Recovery varies, but the shoulder is often immobilized in a sling for a period followed by physical therapy over several weeks. Full strength and stability can take longer. Completing rehabilitation helps prevent future dislocations.
Can a dislocated shoulder happen again?
Yes. After a first dislocation, especially in younger people, the shoulder can become more likely to dislocate again. Strengthening exercises and completing rehabilitation reduce this risk. Repeated dislocations may need surgical repair.
When is a shoulder injury an emergency?
Seek emergency care if the shoulder is obviously deformed, you cannot move the arm, or you have numbness, tingling, coldness, or loss of color in the arm or hand. These can indicate nerve or blood vessel involvement that needs urgent treatment.
References
- American Academy of Orthopaedic Surgeons (AAOS). Dislocated Shoulder.
- Mayo Clinic. Dislocated shoulder.
- MedlinePlus, U.S. National Library of Medicine. Shoulder dislocation.