Dislocation and Instability
Dislocations of the shoulder are fairly common due to the naturally unstable mechanics of the joint.
The shoulder is a very shallow ball and socket joint held together by ligaments, capsule and tendons. There is also a cartilaginous part (the labrum) which helps to deepen the joint. It is this part that may become detached during a dislocation injury. Some people are born with laxity in their joints and may suffer with dislocations with relatively minor movements.
- Trauma. Often occurs as a result of a direct fall onto an outstretched arm, either through an accident or playing sports.
- Hypermobility. People with naturally mobile joints (hypermobile) are more prone to dislocations.
- Pain. Ranging from mild to very severe.
- Severely reduced movement.
- Deformity. The head of the humerus can be seen to be out of alignment.
Some may require reducing – where the joint has to be put back into place in hospital. Others will move back into place naturally. The use of a sling for a few days or weeks may be necessary depending on the Consultant Orthopaedic Surgeons protocol.
Specific rehabilitation is essential to strengthen the muscles and increase control. This may help to prevent further dislocations in the future.
For people who suffer more than one dislocation despite regaining full strength and control, surgery may provide the best long term outcome (Bankharts Stabilisation). People with hypermobility do not usually benefit from surgical stabilisation and are best managed with specific exercises.
