You’re slipping down a hill and grab a tree limb to stop yourself. A nice way to break a fall. But a good way to dislocate your shoulder.
Shoulder dislocations usually occur when you grab something over your head while your full body weight is being pulled downward, or when you break a forward fall with your outstretched arm. Since the shoulder is a ball-and-socket joint, if the ball gets jerked out of the socket and doesn’t go straight back in, muscles and ligaments pull it back tight against the side of the lip of the socket. And there it’s stuck.
For the treatment, well, think about trying to put a ball into a cup. If the ball is stuck tight to the outside part of the cup, there’s no way to get it back in without unsticking the ball or breaking the cup. And if you have a dislocated shoulder, you sure don’t want to break the cup.
How to Diagnose a Dislocated Shoulder
Sometimes a dislocation isn’t visually obvious, even when you compare the injured side to the noninjured side. But if someone’s shoulder is hurting and is hard to move, the cause of the injury can give you a clue about whether it’s dislocated.
If you’re unsure, have the victim touch the opposite shoulder with the fingers on his injured side. Someone with a shoulder dislocation won’t be able to do this. Of course, someone with a break or just a bruise may not be able to do this, either, but if the victim can do it, there’s no dislocation.
Dislocated Shoulder Treatment: Do No Harm
The best way to try to get the joint back in place is to find a way for those shoulder muscles and ligaments to relax just enough so the head of the humerus can slip over the rim of the shoulder cup and back into position. Yeah—easier said than done.
Injured muscles tend to spasm. With time they swell and stiffen even more. So in general, the quicker the joint is put back into place the easier it is to do. However, without an X-ray, dislocation or not, you really can’t tell if a bone is broken or, if so, how badly. So remember the first axiom of treatment: Do no harm. Never force anything.
Until you can get expert care, place the arm in a sling for comfort and apply ice packs or just hold the arm. If help is not going to be available soon, you could try one of the following three treatment options. Even if they work, you should keep the arm in a sling for several weeks, gradually moving and getting range of motion back while giving the muscles and ligaments time to heal.
Dislocated Shoulder Treatment Option 1: Arm Hang
This is the simplest method, with the least chance of additional injury.
- Have the injured person lie facedown on a table, bed, or something else high enough for the arm to hang off the side without touching the floor. The entire arm should hang straight down from the injured shoulder.
- Tape or wrap a weight, ideally approximately 15 pounds, to the hand or lower arm. (A gallon of water is about eight pounds.) Having the victim hold the weight in his hand doesn’t work nearly as well, because to grip an object, you have to tense some muscles.
Soon, the victim should start to relax a bit, realizing that this procedure is not causing any additional pain. As the muscles relax, the head of the humerus will drop below the rim of the socket enough to snap back into place. Usually, the victim will hear or feel a soft pop or just experience a sudden relief of pain, but sometimes it’s too gradual to sense.