My shoulder left its holder

August 21, 2008 9:19 PM

Have I truly dislocated my shoulder? If not, is there anything special I should do?

At judo tonight, someone landed on my arm while it was outstretched, and I was in a crouching position. My shoulder popped out, but after I rolled over, I felt it pop back in. For the next thirty minutes, it hurt like hell, but after an hour, it felt ginger, but painless. A sensei told me that the pain was probably from a stretched nerve, not actual damage.

Unfortunately, it felt good enough that I unwisely decided to stretch it to see how good it was. It was fine stretching over my head, but when I stretched to the side (against the floor) it popped out again, then I immediately turned to the side and popped it back in again. Yeah, I'm not doing that again for a while. The pain went away pretty quickly that second time.

So, I have a full range of motion with it and no pain. Does this mean I didn't "truly" dislocate my shoulder? All the information on recovering from a dislocated shoulder I'm reading is serious business that speaks of pain for days and the ER.

I don't seem to have that, so what should I do? I'm going to try to see a doctor next week, depending on whether my flimsy insurance covers it. If not, am I likely to be in the clear? Do I need to anything other than not stretch it or put pressure on it for a few days?

posted by ignignokt to health & fitness (7 comments total)

I used to dislocate my shoulder regularly. At first, it popped in by itself, but eventually there was enough damage that it would stay out, and various ER techs who reduced the dislocation didn't help with the damage. I don't think it was ever put back the same way twice, and only once did I find a doctor who managed to slip it back in quickly and painlessly. After 10 years or so, it got so bad that it would fall out while I was asleep.

So...if your ligaments stretched enough to let the head of the humerus out of the fossa (and back in again), you may not be too badly off. If you started a tear, that's not so good. If you can get an MRI and a good ortho to read it, you'll be able to get a better treatment plan. IIRC, when I started having problems back around 1985, they just gave me a loop of surgical rubber and showed me some exercises. Strengthening the muscles is good, but you need the ligaments attached, too.
posted by spacewrench at 9:59 PM on August 21, 2008

Dislocated shoulders are a much bigger deal if they occur when you are young (teens or younger?) People who dislocate a shoulder when young are much more prone to later dislocations.

I dislocated mine in my 30s. It took loads of morphine, an MD and a 200+ pound paramedic to pull it back into joint. It felt unstable for a number of months but after that it's been no different than it was prior to dislocation. I went for rehab but didn't follow through because what they told me to do hurt the joint. I'm probably completely wrong but, I don't see how something that exacerbates the pain can be good for a joint injury. I just took great care not to put too much strain on the shoulder for about three months.

On the other hand I know people who have done the same at a later age and have had continuing problems.

Of course, the best thing to do would be to run (without falling down) to an MD. At the very least I would go very easy with it until you don't feel any instability in it. If you don't go to an MD you can find rehab exercises on the intertubes. Whatever you do my uneducated advice would be to take it easy with the joint. (I am a lawyer but not your lawyer).

I just re-read my answer and don't expect it is of much use at all.(Why am I hitting the "post comment" button.)
posted by Carbolic at 10:13 PM on August 21, 2008

Something similar happened to me several years back, during a taekwondo sparring session. My shoulder popped back in after some time and I thought nothing of it till a few months later it popped out while I was getting out of my bed. An ortho I saw (for something else, but I mentioned the shoulder to him) said it was likely to be a subluxation or incomplete dislocation.

I've not had any medical treatment done on my shoulder, although I do know that surgery is an option if it becomes a problem. It pops out once in a while, with the longest interval between two incidents about 4 years... however the latest one was while I was sleeping, which pretty much sucks.

Basically from my experience you don't really need to do much after it pops back in, but you do need to be constantly conscious of using your shoulder and to avoid things that are likely to cause it to pop out again. For anterior dislocations which are what your case sounds like and what mine is, things like throwing a ball overhead tend to cause dislocations, particularly if you use excessive force on the throw. The more times you dislocate the joint, the easier it becomes because the ligaments get stretched or torn. So you just need to be careful.

Another thing that is useful to learn is how to reduce the dislocation yourself (put it back into the socket). The method I was taught recently by a doctor was to lay flat on your bed (or some other horizontal surface), let your arm hang perpendicular to your body, and relax. Eventually gravity is supposed to cause the shoulder to pop back in. I've not had a chance to try this out yet though, fortunately, so I'm not sure how well it works.

I do however suggest you see a doctor if possible, just to make sure there wasn't more damage done than you might think.
posted by destrius at 10:16 PM on August 21, 2008

Well, the morning after, my shoulder isn't in real pain, but it definitely doesn't feel normal. I still have to move it gingerly. Subluxation seems to be the right way to describe what happened.

I'm 31. I hope I'm far enough out of my twenties that it doesn't recur.

Man, I hope my ligaments aren't stretched too badly. Also, I wish I still had good insurance. Anyway, thanks guys. What you said was good to hear.
posted by ignignokt at 7:04 AM on August 22, 2008

I have a similar problem. When it first started happening, about 15 years ago, I could easily pop it back in and it would be better in a few days. Every couple of years it would happen again and I found that popping it back in became increasingly difficult; the last two times I thought I'd have to go to the hospital. But the pain always went away after a few days until the most recent occurrence, when it stuck with me.

My doctor diagnosed me with a chronically dislocated shoulder and explained that there was too much space in my shoulder joint. The only thing holding the arm in is the muscle, and each time it dislocates the ligaments (tendons?) stretch out more, making it worse.

I went to physical therapy and learned some exercises (which have helped quite a bit) and received two other pieces of advice. The first was to maintain good posture. I used to hunch my head and shoulders a bit, allowing the muscles behind the shoulder which I needed for stability to atrophy. The second thing they told me is that I shouldn't stretch out my shoulder too much. Extending my range of motion and loosening up the muscles on the edge of my mobility range are exactly what I don't need.

Hopefully you'll be able to see a doctor about this. Even if your insurance won't follow through with treatment you can at least have them point you in the right direction.

Good luck!
posted by Hermes32 at 8:02 AM on August 22, 2008

I just got back from the doctor. In my case, a week of taking it easy should do the trick.

Also, according to him, recurring subluxation or dislocation often does not happen. In the cases he's seen, it hasn't, and there's no clinical studies that say it's a really common occurrence. So, future dislocators and subluxators, there's a chance you might suffer from recurring dislocations and subluxations, but it seems that most likely, you won't. I hope I'm in the "most likely" crowd.
posted by ignignokt at 3:51 PM on August 22, 2008

Thanks for posting this, folks. I just got back from the ER after dislocating my shoulder.... hurts quite a bit!
posted by ph00dz at 3:11 PM on September 28, 2008