Question:Our college-aged son dislocated his shoulder playing basketball. We are trying to figure out if he needs surgery or not. The staff at the local clinic say he can wear a sling for eight weeks and come out alright in the end. Is this sound advice?
Answer:Studies show that immobilizing the arm after a primary (first) shoulder dislocation doesn't change what happens in the long-run. Even applying the sling several weeks after the dislocation first occurred doesn't seem to change what will happen a year or even more than a year later.
Over half of all shoulder dislocations stabilize and recover well. In fact, according to a study over a period of 25 years, many patients with a shoulder dislocation couldn't even remember which arm was dislocated.
Some experts have advised immediate surgery for anyone with a shoulder dislocation who is an athlete, especially throwing athletes. Results of the long-term study just mentioned did not agree with this counsel. According to their data, athletic activity was not linked with recurrent shoulder dislocation.
A trial period of immobilization followed by a rehab program is considered a good first step following shoulder dislocation. Even if surgery is eventually needed, the strengthening program will prepare the shoulder for a better result after surgical reconstruction takes place.Lennart Hovelius, MD, PhD, et al. Nonoperative Treatment of Primary Anterior Shoulder Dislocation in Patients Forty Years of Age and Younger. In The Journal of Bone and Joint Surgery. May 2008. Vol. 90-A. No. 5. Pp. 945-952.
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