(photo by soldiersmediacenter)

The basic question of the study was:

Is there any advantage to surgically repairing an initial dislocated shoulder on a young, athletic person vs. allowing the injured shoulder to heal in a more conservative, non-surgical fashion?

The conclusion:

Yes, for the group who participated in the study, there were both short– and long-term advantages to having their dislocated shoulders surgically repaired instead of taking the more conservative approach. 

How easy is it to dislocate your shoulder?

As I was doing my initial research into dislocated shoulders, I began to wonder – How easy is it to dislocate your shoulder?  I suffered a separated shoulder (which is a different injury) during a fall while skiing.  What about others?

Bodybuilder dislocates shoulder while closing car trunk

Stew Smith wrote an article entitled “Taking Care of Your Shoulders” in which an avid weight-lifter and bodybuilder wrote in and described how he had dislocated his shoulder while closing the trunk of his car.  Hey, if a big guy like that can dislocate his shoulder that easy, what does that mean for me.  Not much.

Here is a video that demonstrates just how easy it is to dislocate your shoulder

Please don’t try this at home.  I can assure you that it is painful and it takes time to heal – with or without surgery!  And you may be more susceptible to future dislocations as well.

According to Wikipedia – “The shoulder joint is the most frequently dislocated major joint of the body. In a typical case of a dislocated shoulder, a strong force that pulls the shoulder outward (abduction) or extreme rotation of the joint pops the ball of the humerus out of the shoulder socket. Dislocation commonly occurs when there is a backward pull on the arm that either catches the muscles unprepared to resist or overwhelms the muscles.”

Small group of muscles hold your most versatile joint together

It doesn’t matter how big you are, the same small muscle group holds the ball of your humerus and glenoid (socket) together.  They are the group of small muscles that form the rotator cuff. Here are some excellent images.

Exercises that you can do to strengthen the rotator cuff complex

(photo by RubyVrooom and used under this creative commons license)

The construction of the shoulder joint allows it to be the most mobile joint in the body. You can do incredible things with your arms and hands because of the way our shoulders are designed.

• You can throw all kinds of things. If you can grasp it and lift it, then you can throw it.
• You can lift items in front, to the side and over your head.
• You can pull yourself up – if you are strong enough.

The downside is that in order to be the most mobile joint, some stability is sacrificed. The ball of the upper arm bone rests in a very shallow socket called the glenoid. When this ball (of the humerus) is caused to become dislodged from the socket, then the shoulder is said to be dislocated. It can be quite painful and your range of motion will be limited.

Controversial surgery proving effective for young athletes

According to a public release put out on March 8, 2008 by the American Orthopaedic Society for Sports Medicine, a recent study indicates that young athletes who go through a first-time shoulder dislocation and have arthroscopic surgery to repair it are experiencing greater long term benefits than those patients who take the more conservative, non-surgical approach.

The study was performed on young military cadets who are required to be very physically active. If your child is less active, then the conservative non-surgical approach may be a better option.

(photo by PamelaVWhite – creative commons)

Always consult a qualified physician.

Tags: shoulder+dislocation, shoulder+surgery

The shoulder is a complex joint made up of three bones:

• the HUMERUS – the upper arm bone
• the SCAPULA – the shoulder blade
• the CLAVICLE – the collar bone

The scapula has a shallow socket called the glenoid, which the ball of the humerus fits into. The union of these bones is referred to as the glenohumeral–joint or shoulder-joint. (To see a very good animation – click here)

Shoulder Dislocation

When the glenohumeral joint is disrupted, the humerus loses contact with the glenoid and results in the condition known as shoulder dislocation.

Shoulder Separation

The uppermost part of the scapula (shoulder blade) is known as the acromion. The union of the clavicle (collar bone) and the acromion is called the acromioclavicular joint or AC joint. When this joint is disrupted, a shoulder separation / AC separation results.

Shoulder separations classified by severity of injury

Shoulder separations are classified according to the severity of the injury. You may hear it described as different levels, grades, types or degrees of separation.

All joints are held in place by ligaments (extremely tough, tissue structures that connect bone to bone). In the AC joint, one set of ligaments forms the joint capsule around the AC joint (this is known as the acromioclavicular ligament). Two other ligaments connect the clavicle to a bony protrusion of the scapula, called the coracoid process. These are called the coracoclavicular ligaments.

• TYPE I – there is a partial tear of the acromioclavicular ligament (AC ligament), with no change of the position of the clavicle (collar bone).
• TYPE II – there is the rupture of the AC ligament and partial tearing of the coracoclavicular ligament with some change of the position of the clavicle (collar bone).
• TYPE III – there is the rupture of the AC ligament and coracoclavicular ligament, definite upwardly displaced clavicle.
• TYPE IV – there is posterior (rearward) displacement of the clavicle, behind the AC joint.
• TYPE V – there is an upward displacement of the clavicle, puncturing muscle tissue.
• TYPE VI – there is a downward displacement of the clavicle, which becomes lodged beneath the acromion or coracoid process.

TYPE I and TYPE II separations are the most common types of AC separations and rarely require surgery.

TYPES IV, V and VI are rare injuries and commonly result in surgical repair.

TYPE III separations are the most controversial. They are fairly common, but there is still some debate as to whether surgery is the “right” treatment, though surgery may be recommended for high level throwing athletes. Some feel that the joint will heal without surgery if the injury is managed properly.

Surgery for a TYPE III separation usually involves relocating the AC joint and repairing the torn ligaments. The clavicle will also be secured, either by screw or possibly goretex tape, until the ligaments have had sufficient time to heal. If a screw is used to secure the clavicle, then it is normally removed within eight weeks of surgery.

In the event that you are faced with a TYPE III AC separation, consult with your physician about the pros and cons of surgical and non-surgical treatment. Ask about:

• possible physical restrictions you may face
• mobility issues
• the strength of your shoulder
• possible future complications
• your rehabilitation time
• any possible risks

The Good News and The Bad News

The shallow socket that affords you the most movement, is also the same shallow socket that gives you the least amount of stability. This lack of stability makes the shoulder joint the most prone to dislocation.

The 3 Bones that make up the shoulder

• The Upper Arm Bone ( Humerus )
• The Shoulder Blade ( Scapula )
• The Collar Bone ( Clavicle )