Dislocated Shoulder Treatment for External Rotation

"Dislocated shoulder" is the term used to describe an upper arm bone (humerus) that has popped free of the glenoid socket, which is formed inside the shoulder joint by the shoulder blade or scapula. It is characterized by intense pain, obvious deformity of the shoulder joint, bruising, swelling and inability to move the shoulder. Medical treatment is typically needed to repair a dislocated shoulder and restore normal upper arm rotation.

Understanding Shoulder Dislocation

• According to the Mayo Clinic, your shoulder dislocation may be either partial or total. In partial dislocation (also called subluxation), some portion of your humerus will remain in position inside your shoulder joint. In a total dislocation, your entire humerus will lose contact with the glenoid socket. You may experience dislocation either through a direct blow applied to your shoulder or through an extreme rotation of your shoulder joint. Depending on the direction of force on your shoulder, your humerus may displace backward, forward or downward. If the force of dislocation is severe enough, you may injure the tendons or ligaments that normally allow you to lift or rotate your arm.

Initial Treatment

• If you believe you have dislocated your shoulder, you should seek medical attention as soon as possible. Prior to seeing a doctor, you may use an ice pack to reduce swelling and limit internal bleeding and fluid buildup in your shoulder. To begin treatment, your doctor will try to maneuver your humerus back into its socket. This technique is called a closed reduction. If you receive treatment relatively close to the time of your injury, your doctor may perform a closed reduction without the use of an anesthetic. If treatment is not begun within roughly half an hour, anesthetic is typically required.

Rehabilitation and Recovery

• Once your arm is back in place, your doctor will place it in a sling-like device called a shoulder immobilizer, which will limit any movement of your shoulder joint while initial healing is under way. Typically, you will need to use an immobilizer for a period of two or three weeks. Toward the end of this period, you will likely begin performing rehabilitation exercises to help restore proper shoulder movement. Your rehabilitation routine will include exercises specifically designed to restore your external rotation. One potential option here is called an isometric shoulder external rotation, which will require you to use your hand to push your body weight away from a stationary surface such as a doorway. Another potential option is called a resisted shoulder external rotation, which will require you to pull against the force of a strength band or a section of elastic tubing. Long-term recovery from your injury relies in part on you following your prescribed rehabilitation program.

Surgery

• In some cases, surgery may be needed to properly repair your dislocated shoulder. This may be true if nerves or blood vessels in your shoulder are injured by your dislocation or if recurring dislocations have weakened the supporting structures within your shoulder joint. Consult your doctor or surgeon for more information on potential surgical options.