Mobility over stability:
The shoulder joint or glenohumeral joint is a ball-and-socket type synovial joint. It holds one of the greatest ranges of movement of the all the joints in the body, however this greater freedom of movement makes it inherently unstable. With the increased mobility in the shoulder comes a sacrifice of stability, also making it one of the easiest joints in the body to dislocate.
What happens when you dislocate your shoulder?
The head of the humerus, easier thought of as the top part of your upper arm bone, is what moves out of the glenoid fossa, or shoulder socket, during a dislocation. Usually the head of the humerus is held centrally in the glenoid fossa by a combination of passive shoulder stabilisers, including the ligaments and joint labrum, as well as dynamic stabilisers, being the muscles that surround the shoulder and shoulder blade. Dislocation can cause injury to many of these structures within the shoulder and can also damage vascular, bony and nervous structures in the shoulder complex.
How does a shoulder dislocation happen and what does it look like?
Shoulder dislocations can occur in an anterior or posterior direction, with up to 97% of injuries being anterior dislocations. The most common mechanisms of injury include a direct force to the front or back of the shoulder, with the arm in a position of abduction and external rotation, or by falling onto an outstretched hand with the arm externally or internally rotated. Anterior shoulder dislocations will present with the arm held in an abducted and externally rotated position, often with an obvious disruption to the usual contour of the shoulder joint, whilst posterior dislocations will often see the shoulder resting in a position of internal rotation and abduction. Movement will usually be limited and painful with both types of dislocation.
Treatment and Management
Once the shoulder has been relocated it is important to look towards rehabilitating the area to prevent further re-injury. There is a rather high risk of shoulder re-dislocation when returning to sport and daily activities, particularly in the young male population, if the shoulder is not treated properly in the first instance. Treatment and management include an initial period of relative rest, followed by strengthening, mobility and proprioceptive retraining to restore the stability within the joint. Taping can also be performed prior to returning to sport to reinforce stability around the shoulder and help reduce any apprehension.
Our physiotherapists are trained to treat all forms of shoulder and musculoskeletal injuries. If you have any concerns regarding your shoulder give our friendly team a call and come and see one of our physiotherapists!