Shoulder Dislocation (Glenohumeral Dislocation)

What to do right after a shoulder dislocation

• Support the arm in the position that hurts least, using a sling or folded cloth, or holding it against the body.
• Do not let anyone pull or twist it back in unless they are trained. Forced attempts can break bone or damage nerves and vessels.
• Apply ice wrapped in a cloth for 15 to 20 minutes.
• Do not eat or drink in case sedation is needed for reduction.
• Go to the ER or call 911 if there are signs of poor circulation or other serious injuries.

For an overview of symptoms and recovery time, see our main dislocated shoulder page. This page explains the types, associated damage, treatment decisions and rehab in more detail.

Types of shoulder dislocation

Partial slips, where the ball moves partly out and returns, are called subluxations. They also damage the stabilizing tissues.

Damage that comes with a dislocation

• Bankart lesion: a tear of the labrum (the rim of cartilage deepening the socket) at the front-bottom of the glenoid. Present in most first-time anterior dislocations in young people. It is the main reason dislocations recur. See labral tear.
• Bony Bankart: a fracture of the glenoid rim. Large bone loss increases instability and changes surgical options.
• Hill-Sachs lesion: a compression dent in the back of the humeral head where it struck the glenoid rim. Large ones can "engage" the rim and cause repeated dislocations.
• Rotator cuff tear: common in people over 40. Ongoing weakness after a dislocation in an older adult should be checked with ultrasound or MRI.
• Fractures: of the greater tuberosity or the humeral neck (humerus fracture).
• Axillary nerve injury: numbness on the outer upper arm and weak shoulder lifting. Most recover over months.
• Blood vessel injury: rare, more likely in older adults.

How a shoulder dislocation is diagnosed

1. Examination: shoulder shape, arm position, pulses, sensation over the outer arm, and hand movement.
2. X-rays before reduction: to confirm direction and look for fractures, which change how reduction is done. Multiple views are needed to avoid missing posterior dislocations.
3. X-rays after reduction: to confirm the joint is back in place.
4. MRI or MR arthrogram: for young athletes, recurrent instability, or suspected labral or cuff tears.
5. CT scan: to measure glenoid bone loss before surgery.

Treatment

Reduction

A doctor guides the ball back into the socket, usually after pain relief, a joint injection of local anesthetic, or sedation. Common techniques include external rotation, scapular manipulation, the Cunningham massage technique and FARES method. Pain eases dramatically once the shoulder is back in. Some shoulders reduce by themselves.

Immobilization

A sling for comfort, usually for 1 to 3 weeks. Older adults are encouraged to move sooner to prevent stiffness (frozen shoulder). Immobilizing in external rotation has not reliably reduced recurrence.

Physical therapy

• Weeks 0 to 3: pain control, gentle range of motion, elbow, wrist and hand exercises, posture.
• Weeks 3 to 6: active range of motion, early rotator cuff and shoulder blade strengthening, avoiding the combined raised and turned-out position.
• Weeks 6 to 12: progressive strengthening, proprioception and sport-specific drills.
• Return to sport: when you have full painless motion, strength close to the other side, and no apprehension.

Recurrence: who is at risk

The younger you are at the first dislocation, the higher the chance it happens again:

Other risk factors: male sex, contact or overhead sports, a large Hill-Sachs or bony Bankart lesion, and general joint laxity.

When surgery is recommended

Surgery is considered for:

• recurrent dislocations or ongoing instability
• young athletes in contact or overhead sports after a first dislocation, to reduce the high recurrence risk
• significant glenoid bone loss, large Hill-Sachs lesions, or associated fractures
• rotator cuff tears in older adults that cause weakness

Surgical options

• Arthroscopic Bankart repair: the torn labrum is reattached to the socket with small anchors through keyhole incisions. Often combined with remplissage to fill a Hill-Sachs dent.
• Latarjet procedure: a piece of bone with an attached tendon (the coracoid) is moved to the front of the socket to rebuild bone loss and add stability. Used for larger bone loss or failed repairs.
• Open repair and bone grafts for complex cases.

After stabilization surgery, a sling is worn for about 4 to 6 weeks, and return to contact sport usually takes 4 to 6 months.

Outlook

Most people regain good shoulder function. The main long-term issues are recurrent instability in young people and stiffness or cuff weakness in older adults. Repeated dislocations increase the risk of later shoulder arthritis, which is one reason early stabilization is offered to high-risk young athletes.

Frequently asked questions

What is the most common type of shoulder dislocation?

Anterior (forward) dislocation accounts for over 95% of cases. It usually occurs when the arm is raised and forced backward or outward, such as in a fall, tackle or block. Posterior dislocations are rare and typically follow seizures or electric shocks.

What is a Bankart lesion?

A Bankart lesion is a tear of the labrum, the cartilage rim of the shoulder socket, at its front-lower edge, caused by an anterior dislocation. It loosens the shoulder and is the main reason dislocations recur. Arthroscopic Bankart repair reattaches the labrum to the bone.

Should a dislocated shoulder be put back in at home?

No. Attempts by untrained people can cause fractures and nerve or blood vessel injury, and an X-ray is needed first to check for fractures. Support the arm, apply ice, avoid eating or drinking, and go to the ER.

Do I need surgery after my first shoulder dislocation?

Not usually. Many people do well with physical therapy. Surgery after a first dislocation is often recommended for young athletes in contact or overhead sports, because their recurrence risk is high, and for people with large bone injuries or rotator cuff tears.

How long does it take to recover from a shoulder dislocation?

Without surgery, most people regain everyday function in 3 to 6 weeks and return to sport in about 6 to 12 weeks. After stabilization surgery, a sling is used for 4 to 6 weeks, and return to contact sport typically takes 4 to 6 months.