Recurrent Dislocation

Overview

A dislocation occurs when the bones forming a joint are forced completely out of their normal position. Recurrent dislocation means the same joint dislocates again and again, often with less and less force each time. The shoulder is by far the most commonly affected joint because it is the body's most mobile and least inherently stable, but the kneecap, fingers, and other joints can also dislocate repeatedly.

The pattern usually begins with a first traumatic dislocation that stretches or tears the ligaments, joint capsule, and cartilage rim (labrum) that hold the joint in place. Once these stabilizers are damaged, the joint can slip out more easily, sometimes during ordinary activities like reaching overhead or rolling over in bed.

Recurrent dislocations are more than an inconvenience. Each episode can cause further damage to the cartilage and ligaments, and over time this can lead to early arthritis in the joint. People may also begin to limit their activities out of fear that the joint will give way, which affects sport, work, and daily life. Because the problem tends to worsen without treatment, addressing instability early is important.

Symptoms

People with recurrent dislocations often describe:

• The joint visibly or palpably slipping out and then back into place
• A sense of looseness, instability, or the joint about to give way
• Sudden pain when the joint dislocates
• Apprehension or guarding when moving the joint into certain positions
• Numbness, tingling, or weakness around the joint during an episode

Some dislocations reduce on their own, while others require someone to put the joint back into place.

Causes

Recurrent dislocations develop when the joint's stabilizing structures can no longer keep the bones aligned:

• Damage from a first dislocation: Torn ligaments, a stretched capsule, or a labral tear leave the joint loose.
• Bone defects: A dislocation can dent or chip the bone surfaces, removing some of the natural bony stability.
• Naturally loose joints: Generalized ligament laxity makes some people more prone to dislocation.
• Repeated stress: Sports and activities that repeatedly push the joint to its limits can perpetuate instability.

Risk Factors

• A first shoulder dislocation at a young age
• Contact and collision sports such as football, rugby, and hockey
• Generalized joint hypermobility
• Incomplete rehabilitation after the first dislocation
• Overhead and throwing activities
• Previous labral or ligament injury

Diagnosis

Diagnosis combines the history of repeated dislocations with examination tests that gently assess how loose and stable the joint is. Imaging clarifies the damage:

• X-rays: Show the joint position and any bone defects from past dislocations.
• MRI, often with contrast: Reveals labral tears, stretched ligaments, and capsule damage.
• CT scan: Sometimes used to measure bone loss before surgery.

Treatment

Treatment depends on how often the joint dislocates, how much structural damage exists, and the person's activity level:

• Physical therapy: Strengthening the muscles around the joint improves stability and may be enough for milder instability.
• Activity modification and bracing: Avoiding provoking positions and using a brace can reduce episodes.
• Surgery: When dislocations are frequent or limit activity, surgery repairs torn structures or addresses bone loss to restore stability. After surgery, a period of protected motion is followed by progressive rehabilitation to rebuild strength and confidence, and the chance of further dislocation is much lower once the damage is repaired.

If a joint is dislocated and will not go back into place, or if there is numbness, severe pain, or loss of circulation, prompt medical care is needed to reduce it safely.

Prevention

• Complete a full rehabilitation program after any dislocation
• Strengthen the muscles that stabilize the affected joint
• Avoid positions and movements that have previously caused dislocation
• Use protective bracing during high-risk sports if advised
• Discuss surgical options early if instability persists

When to See a Doctor

See a doctor if a joint has dislocated more than once or feels persistently unstable, since untreated instability tends to worsen and can damage cartilage over time. Seek emergency care if a joint is dislocated and cannot be put back, if the limb is numb, cold, pale, or pulseless, or if there is severe pain or obvious deformity after an injury.

Related Topics

Frequently Asked Questions

References

1. American Academy of Orthopaedic Surgeons (OrthoInfo). Chronic Shoulder Instability.
2. Mayo Clinic. Dislocated shoulder — Symptoms and causes.
3. MedlinePlus, U.S. National Library of Medicine. Dislocations.
4. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).