DISLOCATED SHOULDER (GLENOHUMERAL JOINT)
The glenohumeral (GH) joint is the largest and most obvious joint in the shoulder complex. It is described as a “ball-and-socket” joint and consists of an articulation between the glenoid fossa of shoulder blade (which forms the socket) and the head of the humerus (which forms the ball).
One of the many reasons for such a high degree of mobility in the shoulder joint is that the socket of the joint is quite shallow and, therefore, the ball of the joint is able to move throughout its wide range without impeding on the surrounding bone. This is the opposite to the hip, which has a much deeper socket. To combat this instability, the glenohumeral joint relies on the balance, strength and control of muscles, ligaments/capsule and labrum (cartilage) to function properly.
If the shoulder is subjected to an injury (i.e. a rugby tackle) with a force which exceeds the supportive capabilities of the surrounding shoulder ligaments, capsule and/or labrum, the arm bone (humerus) can be forced from the ball-and-socket joint. This can occur in different directions, but the most common dislocation for the shoulder is an anterior dislocation (95% of glenohumeral dislocations), whereby the head of the humerus is forced out of the ball-and-socket joint in a forward direction.
SYMPTOMS OF A SHOULDER JOINT DISLOCATION
As with any new injury, patients will experience immediate pain, swelling and loss of function of the injured arm. In addition, the patient may have felt the arm either “pop out” of its joint and/or felt a “pop” at the time of the injury. There are also often additional symptoms of shock.
If this is the first time that your shoulder has dislocated, the most common course of action is for patients to go to hospital where their shoulder will be reduced (usually without anaesthetic) and immobilised in a sling. Pain killers and anti-inflammatories will also be prescribed and imaging will usually be carried out to make sure there is not an underlying fracture.
DO NOT TRY AND RELOCATE YOUR SHOULDER or let an inexperienced person try and relocate your shoulder, as it is possible to injure the surrounding nerves and blood supply to your upper limb. An experienced medic is needed to carry out this procedure.
The main problem with a dislocated shoulder is the soft tissue injury that occurs as a consequence of the trauma. Long-term, this will mean that, unless the supportive elements of the shoulder are strengthened, it is likely that the shoulder can dislocate again, but this time with a much smaller force. The instability needs to be addressed.
In the case of ongoing recurrent instability after a course of rehabilitation, a referral to an orthopaedic consultant for further evaluation is commonly advised.
(The list of conditions given above and subsequent explanations are intended as a general guide and should not be considered a replacement for a full medical examination. Furthermore, we do not purport to treat all the conditions listed. Should you wish to discuss any of these conditions with our chiropractors, please do not hesitate to phone the clinic on 020 7374 2272 or email firstname.lastname@example.org).