Swapping Activities for a Stable Shoulder: The Slippery Slope of Shoulder DislocationHave you heard the one about the man who went to his doctor with a bad shoulder?
Patient: "Doctor, it hurts when I do this." (The patient moves his arm up and down.)
Doctor: "Then stop doing that."
It's natural to assume that if you dislocate your shoulder during an athletic activity, you should find another activity or sport to play. In fact, this is often the case. Many patients do change to activities with less strain on the shoulder. But this may not always be necessary.
A group of Austrian doctors studied 500 cases of shoulder dislocation. They hoped to identify patients with the highest risk of dislocating the shoulder again (called a "recurrence"). The goal was to advise these patients to have surgery to repair and stabilize the shoulder joint.
The doctors compared patients who dislocated their shoulders again with those who didn't. They found that putting the arm in a sling and going to physical therapy did not prevent a second dislocation. Patients with fractures along with the dislocation had less risk of dislocating the shoulder again. Anyone with decreased shoulder movement, especially turning the arm out from the side, also had less risk of recurrence.
The most reliable risk factor for another shoulder dislocation was age. Patients between the ages of 21 and 30 were more likely to dislocate the shoulder again. This was because these patients continued to do high-risk sports or returned to full activity too soon after injury.
In the Alpine region of Austria, doctors recommend surgery to repair shoulder dislocations. This advice is aimed at adults between 21 and 30 years of age who do high-risk sports. The surgery should be done early, without waiting for another shoulder dislocation. This step is not recommended for patients between 21 and 30 who do not do high-risk activities.
Franz S. Kralinger, MD, et al. Predicting Recurrence After Primary Anterior Shoulder Dislocation. In The American Journal of Sports Medicine. January/February 2002. Vol. 30. No. 1. Pp. 116-120.
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