Shoulder Instability Associated with a Dislocated Shoulder
The shoulder joint is the most mobile joint in the human body. Due to its function and mobility, it is susceptible to recurrent instability after injury. Shoulder dislocations are common injuries in the active population due to an acute injury. The patient usually experiences severe pain and limited mobility after dislocation until the joint is reduced. Some patients will experience the shoulder pop out followed by spontaneous reduction back into the joint. These patients will generally have less pain. Dr. Jervis Yau, orthopedic shoulder specialist serving the Santa Barbara, Goleta, Santa Maria and Ventura, California communities, specializes in diagnosing and treating shoulder instabilities.
Shoulder dislocations occur when the ball (humeral head) separates from the socket (glenoid) during injury. In order to dislocate, the labrum and joint capsule are torn from its attachment site. These injuries are commonly seen in contact sports such as football, basketball, soccer, and hockey. Pain from subtle instability without dislocation can also be seen commonly in overhead athletes due to constant, repetitive overhead motion causing wear and tear to the labrum and capsular ligaments.
Once a shoulder becomes dislocated, it loses some level of stability despite healing of the ligaments. Patients who experience a shoulder dislocation are prone to recurrence due to improper healing of the disrupted soft tissue structures. Recurrent shoulder instability can often be seen in patients who dislocate at a young age with the highest risk of recurrence in patients under the age of 21.
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Dislocated Shoulder and Shoulder Instability Symptoms
Various symptoms are associated with shoulder dislocation and instability, including:
- Severe shoulder pain
- Limited range of motion
- Arm numbness
- Shoulder weakness
- “Popping” sensation
- Muscle spasm
- Swelling, discoloration and bruising
Dislocated Shoulder and Shoulder Instability Diagnosis
Prompt medical care at a local ER should be sought if a patient experiences a dislocated shoulder. Emergency care is critical to place the shoulder back into its normal position, known as reduction. Trained medical professionals may utilize several methods to manually manipulate the injured shoulder in order to place the ball back into its socket.
Dr. Yau will complete medical review and physical examination once the affected shoulder is reduced. A series of x-rays and shoulder MRI may be performed to determine the extent of injury. These diagnostic tests will help Dr. Yau determine the likelihood of developing recurrent shoulder instability.
Dislocated Shoulder and Shoulder Instability Treatment
Dr. Yau will determine the proper treatment plan based on extent of injury, number of previous dislocations, patient’s age and patient’s activity level.
After the dislocated shoulder is reduced, Dr. Yau typically prescribes rest, ice and arm immobilization for several weeks as the soft structures heal. A detailed physical therapy program usually begins after the dislocation to restore range of motion and strengthen to the shoulder.
In cases where a dislocated shoulder leads to ongoing instability, Dr. Yau will recommend an AC joint surgical repair to repair and tighten the damaged ligaments, capsule and labrum. This arthroscopic procedure is highly successful in restoring shoulder stability in most patients. An open surgical procedure may be recommended in cases of severe instability, bone loss, failed arthroscopic surgery or a locked dislocation that cannot be manually reduced.
For additional resources on a dislocated shoulder and shoulder instability, please contact Dr. Jervis Yau, orthopedic shoulder specialist in the Santa Barbara, Goleta, Santa Maria and Ventura, California area.