I watched at a soccer game as the assistant coach helped a young player put his shoulder back in place after dislocating it. I was pretty surprised someone could do this on the field. The question is -- will it hold if surgery wasn't done to repair the torn ligaments and muscles?
Falls from skiing accidents, sports injuries, car accidents and other traumatic events account for many first-time shoulder dislocations. When the shoulder doesn't pop back in place on its own, the patient ends up in the emergency department or doctor's office for a reduction (put it back in the socket). There are many ways to reduce the shoulder but most require anesthesia to put the patient asleep and relax the muscles or strong narcotic medications for pain.
The fact that it was possible to reduce the shoulder on the field suggests that perhaps it was only partially dislocated and more therefore easily put back in place. Not all first-time shoulder dislocations (partial or complete) actually result in ligament rupture or torn muscles.
The soft tissues certainly have to stretch quite a ways when the shoulder is pulled out of the socket. But with rest in a sling during the acute phase and a rehab program later to strengthen the muscles and restore normal motion, many people never experience another shoulder dislocation again.
Surgery is only needed if there is chronic instability -- the shoulder dislocates over and over with minimal provocation. When just reaching the arm up over head causes it to pop out of the joint, surgery is considered. Or when the person has constant, severe pain, surgery may be the only successful alternative. But again, most patients are advised to follow a rehab program for at least six months before going with surgery.
Kazu Matsumoto, MD, PhD, et al. Anterior Dislocation of the Shoulder: A Simple and Sitting Method for Reduction. In Current Orthopaedic Practice. May/June 2009. Vol. 20. No. 3. Pp. 281-284.
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