Ngā pokohiwi pāhekeheke me ngā pakokitanga Unstable shoulders and dislocations

If the ball of your shoulder joint moves partially out of its socket, this is called subluxation. If it moves completely out of the socket, it is called dislocation.

Your shoulder joints can dislocate forwards (anterior dislocation) or less commonly backwards (posterior dislocation).

An accident that causes severe force to or over rotation of your shoulder can cause a dislocation, for example:

• falling from a ladder while holding on
• a collision during a contact sport
• a car accident.

But if you are more flexible than average or have had a shoulder dislocate before, it can dislocate with simple movements like rolling over in bed.

Anterior dislocation does not happen much in tamariki but is common in 18 to 25-year-olds, often resulting from sports injuries. It is also quite common in older people who may have less stable shoulder joints because their muscles are wasting and who are also more likely to fall.

If you have an unstable shoulder, you can do some exercises at home that will help. A physiotherapist can advise you on the best ones for you.

If you have dislocated your shoulder, you will usually be able to see and feel that your shoulder is out of place. You will feel severe pain and be unable to move your shoulder. You may also notice numbness or tingling in your neck or down your arm.

If you think you have dislocated your arm, you need to get medical help immediately.

The healthcare provider will ask what happened and examine your shoulder, arm and neck. They will usually do an x-ray to make sure nothing is broken before the shoulder is put back in the right place. 

You will need your shoulder put back into the right place (this is also called reducing the dislocation). Depending on the experience of the healthcare provider you have gone to, they may or may not be able to put it back into place.

If your healthcare provider is not experienced in putting back (reducing) dislocated shoulders, they may refer you to an urgent care clinic or emergency department.

A dislocated shoulder can often be reduced with no medication, or you may need medicines for pain relief and light sedation. Sometimes a general anaesthetic is needed, but this is unusual.

If you have broken your shoulder as well as dislocated it, you might need surgery to fix the pieces back into the right place. An orthopaedic surgeon will do this.

Once your shoulder is back in place, you will need to have your arm in a sling for 1 to 2 weeks. Your healthcare provider or physiotherapist will let you know how long you need to wear it.

While you have the sling, you should wear it all the time (including at night) for at least the first few days.

During this time, you may need simple pain relief such as paracetamol or ibuprofen.

Pain relief medicines for adults (internal link)

After that, when you are not wearing the sling, let your tissues heal by taking care for 6 weeks. Take extra care when showering, bathing and dressing.

It will take 12 to 16 weeks for your shoulder joint to heal fully. During that time, you should avoid:

• any throwing movement if your shoulder dislocated forwards
• exercises like press-ups, burpees or planks if your shoulder dislocated backward.

Also avoid any contact sports and activities that could put stress on your shoulder until your healthcare provider or physiotherapist says it is okay.

You should see a physiotherapist who can help you get:

• full movement and strength back
• back to what you were doing before your accident.

Allied health (physiotherapy) — Healthpoint (external link)

Find a physio — Physiotherapy New Zealand (external link)

If you had your dislocated shoulder put back in place at an emergency department or you saw an orthopaedic surgeon, you may get a follow up appointment at the outpatient clinic to see how you are getting on.