Joint dislocation, especially in the shoulder, is an injury that is painful and causes the sufferer to be temporarily unable to move (the joint is impossible to move until its position is restored or restored to its original position). The shoulder is very susceptible to dislocation because it is the most movable joint in the body. In addition, people are also prone to falling in an outstretched position, causing the shoulder joint to change position. Shoulder dislocations should be repaired or restored by a medical professional. However, you will have to recover it yourself in certain situations (emergency). If not treated promptly, these injuries may eventually have to be treated with surgery.
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Part 1 of 3: Coping with a Shoulder Dislocation
Step 1. Recognize the symptoms
Shoulder dislocations are usually caused by a fall with the arms outstretched or a blow to the shoulder from the back. This injury causes sudden, severe pain that is preceded by the feeling and/or sound of bone detaching from the joint. After that, the shoulder will appear deformed and abnormal, and accompanied by swelling and bruising that develops quickly. The shoulder will not be able to move until its position is restored to its original position.
- The dislocated shoulder hangs lower than the normal shoulder. In addition, you can usually see a depression or groove in the lateral (deltoid) muscle of the shoulder.
- A dislocated shoulder may also cause a tingling sensation, numbness, and/or weakness in the arm and hand. If a blood vessel is damaged, the forearm or hand on the injured side will feel cold and blue.
- Approximately 25% of first-time shoulder dislocations involve a fracture of the upper arm (humerus) or shoulder circumference.
Step 2. Avoid moving your arms
While waiting for medical attention, you should not move (or even try to move) the dislocated shoulder because of the risk of exacerbating the injury. Fractures, nerve or blood vessel damage are also possible, so any movement is very risky. Instead, bend your elbows, place your forearms against your stomach, and keep them in position with support.
- If you don't have a shoulder brace ready to use, make your own from pillowcases or clothing. Place this brace under your elbow/forearm and tie the ends around your neck. These braces can keep the shoulder in position and protect it from further injury, and often reduce pain as well.
- About 95% of shoulder dislocations occur anteriorly, which means the upper arm bone (humerus) is pushed forward out of the joint cavity.
Step 3. Apply ice to the shoulder
Applying ice or a cold object to the dislocated shoulder joint as soon as possible is very important to inhibit inflammation, which usually has the effect of reducing pain. The ice will constrict the small blood vessels, reducing the blood supply and inflammation that gets to the area around the injury. Apply an ice cube to your shoulder for about 15-20 minutes at a time (or until the area feels numb) every hour or so.
- Always wrap ice in a cloth, towel, or thin plastic bag before applying it directly to the skin to prevent frostbite or skin irritation.
- If you don't have ice cubes at home, use frozen vegetable bags or frozen gel bags instead.
Step 4. Use pain medication
Once the dislocated shoulder is stabilized and iced, consider using pain medication to further suppress the inflammation and pain. The pain of a dislocated shoulder is often unbearable from stretched and/or torn ligaments, tendons, and muscles, as well as the potential for fractures and cartilage fractures. Ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn) are probably the best choices because they are strong anti-inflammatory drugs. However, parcetamol (Panadol) can also be useful for pain relief.
- In the case of a dislocated shoulder with internal bleeding (marked by bruising), avoid taking ibuprofen and naproxen as they both tend to "thin" and inhibit blood clotting.
- Muscle relaxants may also be given if the muscles around the dislocated joint spasm. However, never mix different drugs at the same time. Just choose one of them.
Part 2 of 3: Restoring Joints in Emergency Situations
Step 1. Self-reposition the joint only in emergency situations
Under normal circumstances, waiting for medical help to arrive is the best and safest step for you. However, sometimes this is not possible. If you are in isolation and away from medical help (such as when camping, hiking, or traveling abroad), the potential risk of repositioning yourself or your friends and family members may not outweigh the effects of temporary and temporary pain relief. Increases arm/shoulder range of motion.
- The general rule is, if you can get medical help within 12 hours, wait patiently and try to reduce shoulder discomfort with ice, pain relievers, and a brace. If you have to wait any longer, especially if you have to move your shoulder to get to the hospital, then reinstating your shoulder should be considered.
- The main complications of trying to reposition the shoulder on your own include: exacerbation of torn muscles, ligaments and tendons, damage to blood vessels and nerves, life-threatening bleeding, severe pain that leaves you unconscious.
Step 2. Ask for help in an emergency
If you are forced to reposition your own shoulders in an emergency, understand that it is almost impossible to do so without the help of someone else. Thus, seek help from others in an emergency situation. People may be reluctant to help you for fear of aggravating the pain or injury, so try to reassure them and relieve them of any responsibility.
- If you have to help another person reposition their shoulder, be sure to get their consent and make it clear that you are not medically trained (if so). If this ends up being a problem, don't get legally sued just for trying to help.
- If you have a cell phone and can use it, try calling emergency services for advice and help. Even if medical personnel cannot be immediately dispatched to assist you, emergency services may be able to provide helpful guidance.
Step 3. Lie on your back and pull your arms up
The easiest way to get your shoulder back in position is probably to lie on your back while extending the injured arm perpendicular to your body. Next, ask a friend or someone around you to gently pull your hand or wrist firmly. The person helping you may have to press the soles of their feet against your torso to strengthen the pull. Pulling the arm in this angle allows the humerus to move down the shoulder blade and back into the shoulder cavity with relative ease.
- Remember to slowly steady your arms (not too fast or jerky) away from your body until your shoulders return to their original position. If successful, you will hear a "click" sound and feel your shoulders return to their original position.
- As soon as the shoulder returns to its original position, the pain from the injury will be much less. Only, your shoulder is still unstable. So if possible, make a support and stabilize its position.
Part 3 of 3: Seeking Medical Help
Step 1. Visit a doctor as soon as possible
Visiting a doctor (or a trained medical practitioner) quickly is essential for dislocation of the shoulder as the surrounding muscles, tendons and ligaments tighten, making it very difficult to restore the head of the humerus without surgery. Most doctors will probably recommend an X-ray of the shoulder before taking any action to make sure the bones in the shoulder are not broken.
- If there are no broken or heavily torn parts, the doctor can perform a closed reduction procedure on the shoulder joint. In this procedure, you may need sedatives, strong muscle relaxants, or even general anesthesia because of the severe pain that accompanies it.
- A common reduction in the shoulder joint is known as the Hennepin maneuver, which utilizes external rotation of the shoulder. While lying on your back, your doctor will bend your elbow 90 degrees and gradually rotate your shoulder outward (external rotation). A gentle push in this position is usually enough to bring the shoulder joint back into position.
- There are many other reduction techniques that the doctor may use, depending on which he or she deems appropriate.
Step 2. Prepare for the possibility of surgery
If your shoulder is frequently dislocated (due to bone deformities or weak ligaments), or if you have broken bones, nerve/blood vessel damage, you may need surgery to correct and reposition your shoulder with open reduction. Surgery is sometimes the best option because it can repair internal damage and stabilize the joint, greatly reducing the risk of future dislocation.
- There are many other operations performed. The choice of surgery used is determined, among other things, by the severity of the injury and the patient's lifestyle/activity level.
- Several studies suggest that open reduction surgery is the best option for active adults less than 30 years of age because of its lower recurrence rate and better quality of life outcomes.
Step 3. Undergo shoulder rehabilitation therapy
Regardless of whether you undergo closed manual reduction or surgical open reduction, you should seek a referral to a physiotherapist and undergo shoulder joint strengthening therapy. Physiotherapists, chiropractors, and/or athletic therapists can show you specific stretching exercises to restore full range of motion of the shoulder, as well as strengthening and toning exercises to prevent future dislocations.
- The recovery period needed before undergoing rehabilitation therapy with a physiotherapist is usually between 2-4 weeks. Wearing braces, applying ice, and taking pain medication are all part of recovery.
- The total time required to rehabilitate and recover from a dislocated shoulder ranges from 3-6 months, depending on the severity of the injury and whether the patient is an athlete.
Tips
- A few days after the pain/inflammation has subsided, applying a hot, moist compress to the shoulder may help to relax stiff and sore muscles. Herbal pillows that can be heated in the microwave are suitable for use. Only, limit the provision of heat therapy for 15-20 minutes at a time.
- Once your shoulder is dislocated, you're more at risk for a dislocated injury later in life, especially if you play contact sports.
- Get your shoulder back in position as soon as possible after the injury, because the longer you wait, the harder it will be to get your shoulder back in position.
- A shoulder dislocation is different from a shoulder ligament injury. Shoulder ligament injuries are caused by sprains of the ligaments that support the collarbone at the front of the shoulder cavity. The glenohumeral joint is not dislocated.
