Dr. Carlos Rebollón
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Shoulder dislocations, also known as shoulder joint dislocations, are a type of injury that requires immediate medical attention for quick and efficient resolution. If you find yourself in this situation, do not hesitate to contact me right away! My career as an orthopedic specialist, my extensive experience, and the multiple international specializations I have obtained in over 12 countries support my knowledge and advanced techniques for addressing dislocation problems regardless of their complexity.
Let’s remember that the shoulder joint has the widest range of motion in the human body, making it an area that requires extreme care. Despite its relatively small size, the shoulder is composed of three bones, a joint capsule, and the muscles and tendons of the rotator cuff. If any of these structures fail or suffer a significant trauma, it can result in a dislocation.
So, what is a dislocation? It is the displacement of the humeral head from the glenoid cavity, and prompt medical assistance is the only viable option to ensure successful recovery of limb function.
TYPES OF SHOULDER DISLOCATIONS
Dislocations can occur naturally (due to wear and tear or insufficiency in the shoulder structures) or as a result of direct trauma. The main types of injuries involved in dislocations are as follows:
This type of dislocation occurs due to falls, collisions, blows, or contact sports. Generally, the front ligaments of the shoulder are affected, leading to a dislocation.
This injury is present in 85% of shoulder dislocations and is caused by the tearing or wearing down of the labrum.
OVERUSE OR REPEATED ACTIVITY:
Sports that require constant and prolonged movements over extended periods, such as swimming, volleyball, or tennis, tend to weaken the ligaments over time, leading to dislocation. Overloading the joint due to strenuous work is also included in this category.
HILL-SACHS LESION OR FRACTURE:
This is caused by a posterior shoulder dislocation, resulting in a fracture that directly affects the upper part of the humeral head.
Multidirectional instability occurs when the shoulder becomes unstable without any specific cause or trigger. Patients with this condition have loose and fragile ligaments in their body. According to studies, this rare pathology is linked to a specific condition in the genetic structure of collagen.
How is a dislocation diagnosed?
Patients with a dislocation present with visible shoulder dislocation from the start, acute pain, and an inability to rotate the arm. To provide a diagnosis, we will first perform a physical examination with various exploration maneuvers throughout the joint structure while also investigating the patient’s medical history.
In some cases, imaging tests such as X-rays or MRIs may be recommended to obtain a more detailed and specific visualization of the internal injury.
HOW IS A SHOULDER DISLOCATION TREATED?
Shoulder dislocations can be treated either surgically or nonsurgically, depending on the level of complexity of the injury. It is important to emphasize that early surgery has shown incredible results for traumatic injuries with labrum tearing.
As mentioned earlier, after the physical examination, the next step in treating a shoulder dislocation is to employ closed reduction techniques to relocate the dislocated bone back into its original socket.
Patients who experience recurrent dislocations due to ligament weakness are more likely to require surgery to provide better anchoring and support to the joint area.
Immobilization is another essential step in the treatment of shoulder dislocations, where a splint or sling will help keep the shoulder stable for a few days or weeks (depending on the severity of the injury).
To make the treatment less painful, the doctor may prescribe painkillers or muscle relaxants while the shoulder heals. Once the immobilizer is removed, the patient can gradually begin the rehabilitation stage to regain mobility, strength, and stability in the dislocated shoulder.
If during the initial physical examination the doctor notices or suspects the presence of additional internal injuries along with the shoulder dislocation, it is likely that you will require an X-ray. This will provide further information and confirm (or rule out) the presence of broken bones, damage to blood vessels, or nerves.
When the diagnosis of internal injuries is positive, the doctor will propose arthroscopic surgery or open surgery to repair the damage.
This is a minimally invasive closed surgery that uses an arthroscope as a tool to visualize and repair damaged structures through small incisions.
In extreme cases, extensive repair may be necessary to allow a wide view of the injury with enough space to perform the respective techniques.
KINESIOTAPING TREATMENT FOR SHOULDER DISLOCATION
Kinesiotaping techniques have proven to be very useful in the recovery of joint, muscle, ligament, and neurological injuries. Kinesiotape uses special adhesive tapes that are strategically placed on the injured area to provide support and stability without restricting movement.
This type of muscle taping also helps relieve pain from a specific injury, reduce swelling, and improve blood flow. Kinesiological therapy in Panama has become a favorite among athletes as it optimally contributes to sports performance.
PHYSIOTHERAPY TREATMENT FOR SHOULDER DISLOCATION
Once the reduction and initial rest phases are completed, physiotherapy is recommended to complete the full recovery plan. Physiotherapy treatment for shoulder dislocation consists of controlled exercises performed by a specialist in the field with the aim of fully restoring joint mobility and strengthening the muscles involved in the joint to prevent the injury from recurring.
Avoiding activities or sports that can exacerbate the current symptoms.
Prescription of anti-inflammatory drugs to counteract associated discomfort.
Physiotherapy therapies that promote strengthening and increased stability of the shoulder.
WHAT IS THE RECOVERY TIME AFTER TREATMENT FOR SHOULDER DISLOCATION?
During the first few days, the patient will use a sling. At the end of the initial rest period, the doctor will provide instructions to begin the stage of static stability exercises and ligament rehabilitation. All of this will positively influence shoulder mobility and prevent conditions such as adhesive capsulitis. Later on, in what is considered the second stage of rehabilitation, new dynamic activities will be added to the previously mentioned exercises.
The shoulder joint is one of the most complex and heavily used joints in the human body, which is why it requires an extremely careful recovery process with constant supervision, especially when engaging in competitive sports.
In a conservative treatment without surgery and without internal damage, the recovery phases are as follows: Initial rest (immobilization) after reduction for an estimated period of 2 to 3 weeks, supported by oral analgesic and anti-inflammatory medication. Subsequently, passive mobility exercises are performed to regain elasticity and muscle tone for 2 or 3 weeks. Once this time has passed, the patient will enter the phase of active function, toning, and coordination for a few more weeks.
WHAT IS SHOULDER DISLOCATION?
Shoulder dislocation occurs when the humeral head is displaced and comes out of its location within the shoulder blade. Dislocation can occur either completely or partially (subluxation).
Additionally, there are various forms in which the shoulder can dislocate, including anterior, posterior, and inferior dislocations, each showing different characteristics based on its type.
WHAT CAUSES SHOULDER DISLOCATION?
Shoulder dislocations often occur in athletes due to the forced and repetitive movements demanded from the joint during training and games. However, they can also result from falls, collisions, trauma, or direct contact sports.
WHAT ARE THE SYMPTOMS OF SHOULDER DISLOCATION?
Shoulder dislocations are characterized by a visible protrusion or deformity and acute pain from the moment of the incident. Other symptoms that the injured person may experience include instability, bruising, and stiffness in normal joint movement or throughout the entire limb.
Severe cases involving nerve damage can have additional symptoms such as numbness, tingling, and a sensation of pins and needles.