A dislocated shoulder hangs lower than the uninjured side and you can usually see a depression or groove in the lateral (deltoid) muscle of the shoulder. A shoulder dislocation may also cause numbness, tingling and/or weakness down the arm and into the hand. If blood vessels are damaged, the lower arm and hand on the injured side will feel cold and turn a bluish color. About 25% of first-time shoulder dislocations involve fractures of the upper arm (humerus) or shoulder girdle. [3] X Research source
If you don’t have access to a ready-made sling, then make one from a pillow case or article of clothing. Put the sling under your elbow/forearm and tie the ends around your neck. Slings immobilize and protect the shoulder from further injury, and often greatly reduce the degree of pain. About 95% of shoulder dislocations are in the anterior direction, which means the upper arm bone (humerus) is pushed forward out of its socket. [5] X Research source
Always wrap ice in a thin cloth, towel or plastic bag before applying it to bare skin — it’ll help prevent frostbite or skin irritation. If you don’t have access to crushed ice or ice cubes, then use some frozen veggies from the freezer or a frozen gel pack.
For a dislocated shoulder that also involves significant internal bleeding (you’ll see lots of bruising), avoid ibuprofen and naproxen because they tend to “thin” the blood and reduce its clotting ability. A muscle relaxant medication might also be indicated if the muscles around the dislocated joint are spasming. However, never mix different types of drugs concurrently — pick one or the other.
As a general rule of thumb, if you can get medical assistance within 12 hours, then wait patiently and try to reduce the discomfort with ice, painkillers and a sling. If a much longer waiting time is apparent, particularly if you need some mobility in your shoulder to get to a hospital, then relocating your shoulder might be considered. The main complications related to trying to relocate your own shoulder are: further tearing muscles, ligaments and tendons; damaging nerves and blood vessels; life-threatening bleeding; severe pain that results in loss of consciousness. [8] X Trustworthy Source Mayo Clinic Educational website from one of the world’s leading hospitals Go to source
If you’re needed to help someone else relocate his shoulder, make sure to get his consent and tell him clearly about your lack of medical training (if applicable). You don’t want to face any litigation for trying to be helpful if things go wrong. [9] X Research source If you have a phone and can make a call, try contacting emergency services for advice and support. Even if they can’t send medical personnel to you right away, they may be able to offer helpful instructions.
Remember to use a slow, steady pull (without any fast or jerky movements) directly away from the body until the shoulder re-articulates. If it successful, you will hear a “clunk” and feel the shoulder get back into position. As soon as the shoulder relocates, the level of pain associated with the injury will reduce significantly. However, the shoulder will still be unstable, so make a sling and immobilize the arm if possible.
If nothing is broken or badly torn, then the doctor can perform a closed reduction maneuver on the shoulder joint, although you may need a sedative, strong muscle relaxant or general anesthetic before the physical manipulation can be done due to the severe pain. A common reduction method for the shoulder joint is called the Hennepin maneuver, which utilizes external rotation of the shoulder. [12] X Research source While laying flat, the doctor will flex your elbow to 90 degrees and gradually rotate your shoulder outward (external rotation). Some gentle pushing while in this position is usually enough for the joint to relocate. There are a handful of other reduction techniques that doctors use — it depends on what they feel comfortable with.
There are many different surgical procedures that are performed, so it depends on the extent of the damage and the patient’s lifestyle/activity level as to which technique is used. Some studies suggest that surgical “open” reduction may be the best course of action for active adults younger than 30 years due to lower recurrence rates and better quality of life outcomes. [14] X Research source
It often takes two to four weeks of recovery before a referral to physical therapy is appropriate. Wearing a sling, applying ice and taking over-the-counter medications is all part of the recovery phase. [16] X Research source The total time to rehabilitate and recover from a shoulder dislocation ranges from three to six months, depending on the severity of injury and if the patient is an athlete or not. [17] X Research source [18] X Research source
