Before your visit, write down questions you want answered. Bring someone with you to help you ask questions and remember what your provider tells you. At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you. Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are. Ask if your condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean. Know what to expect if you do not take the medicine or have the test or procedure. If you have a follow-up appointment, write down the date, time, and purpose for that visit.
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What causes a dislocated shoulder? The most common causes of shoulder dislocations are Sports injuries Accidents, including traffic accidents Falling on your shoulder or outstretched arm Seizures and electric shocks, which can cause muscle contractions that pull the arm out of place Who is at risk for a dislocated shoulder? What are the symptoms of a dislocated shoulder?
How is a dislocated shoulder diagnosed? What are the treatments for a dislocated shoulder? The treatment for dislocated shoulder usually involves three steps: The first step is a closed reduction, a procedure in which your health care provider puts the ball of your upper arm back into the socket.
You may first get medicine to relieve the pain and relax your shoulder muscles. Once the joint is back in place, the severe pain should end. After a shoulder has dislocated or subluxed, it is important to rest it and avoid aggravating activities for a couple of days. If the pain is significant, such as following a traumatic dislocation, a sling is often used to provide temporary immobilization — shoulder bracing may also be an option for some patients. Once the pain and swelling have subsided, range of motion exercises are started.
Strengthening exercises can begin as motion improves. Typically, the exercise program is done in conjunction with a trained physical therapist. Applying cold packs or ice bags to the shoulder before and after exercise can help reduce the pain and swelling. You should check with your physician with any questions, as a number of different kinds of drugs are available, and they may have side different effects.
The goal of therapy is to restore shoulder motion and increase the strength of the muscles around shoulder. Strong muscles, especially those of the rotator cuff, are required to protect and prevent the shoulder from re-dislocating or subluxing. Once full function of the shoulder has returned, the patient can gradually return to activities. Despite a course of physical therapy in which full shoulder motion and strength are restored, the shoulder may still be loose or unstable.
Treatment options then consist of 1 activity modification and 2 surgery. Activity modification is primarily an option for patients who experience instability only with certain activities, such as playing basketball or overhead racquet sports.
In these patients, avoidance of the activity can completely eliminate their episodes of subluxation or dislocation. Surgical treatment is considered in patients not willing to give up the activities or sports that provoke their episodes, and in patients in whom instability occurs during routine daily activities dressing, sleeping, etc.
The surgery includes examination of the shoulder under anesthesia to fully assess the extent and direction of the instability while the muscles surrounding the shoulder are completely relaxed. An arthroscope is frequently used to inspect the inside of the shoulder joint to evaluate the joint and its cartilage. The arthroscope allows direct assessment of the condition of the labrum and rotator cuff tendons. In a limited number of select patients in whom the degree of looseness or laxity is relatively mild, it may be possible to stabilize the shoulder by arthroscopic techniques.
To correct severe instability, open surgery is often necessary. An incision is made over the shoulder and the muscles are moved to gain access to the joint capsule, ligaments and labrum Figure 6. These structures are then either repaired, reattached or tightened depending on the tissue injury identified at surgery Figure 7.
The repair can be done with simple sutures or with sutures attached to metal or secured to plastic or absorbable tacks or anchors. These anchors are inserted into the bone and hold the sutures that are used to reattach or tighten the ligaments. These anchors stay in the bone permanently.
The course of recovery following surgery depends somewhat upon the type of procedure the surgeon performs. Usually, range of motion of the hand, wrist and elbow begin the day after surgery.
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