The shoulder joint is one of the most flexible joints of the body. With the help of the shoulder joint, one can do various hand movements. Since it is such a loose joint, it is also prone to dislocations. Professional athletes who have to use their shoulders a lot are more susceptible to shoulder dislocations. Wear and tear due to repetitive movement, injury, or shoulder trauma are among the top reasons for shoulder dislocations.

Shoulder dislocation is very painful to the patient, and it causes severe discomfort in performing today’s activities. 

Basics of shoulder dislocation 

The shoulder can be dislocated, entirely or partially, and it can dislocate forwards, backwards or downwards. People in the age group of 16 to 25 are more prone to shoulder dislocations.

Shoulder dislocation immediately causes pain, and the shoulder appears out of place. Some patients also have an altered sensation in the arm.

• The most common shoulder dislocation applies in the forward direction, whereby the ball moves forwards out of the joint. 
• A posterior or backwards dislocation means the arm is outstretched in front, forcing the ball backwards out of the socket. 
• A downwards dislocation occurs when the person has fallen with their arm above the head. 

As soon as shoulder dislocation occurs, the patient should rush to the emergency room of a hospital so that the dislocated joint is immediately pushed back into its proper location. This process is known as shoulder reduction. After reducing the shoulder of the arm is placed in a sling for one to three weeks based on the severity of the injury. Sometimes this itself is sufficient along with regular physical therapy. 

Recovery from non-surgical treatment for shoulder dislocation takes 2 to 3 months, based on the physical therapy that the patient has. If surgery has been performed, the recovery period could be between 3 to 6 months.

Top 5 myths about Shoulder dislocation surgery

Myth 1: Surgery is the only option to treat shoulder dislocations

Fact: Surgery is not suggested for every dislocation. It is recommended only in the case of:

• If the soft tissues that stabilise the shoulder are torn or strained after shoulder dislocation.
• If you experience frequent dislocations.
• If a dislocation causes damage to the bones in the joint.
• If an athlete is involved in sports requiring frequent throwing motions or collisions

Under these conditions, surgery is done to repair or tighten the damaged structures, improve joint stability, and prevent future dislocation. The majority of stabilisation procedures are performed arthroscopically (keyhole surgery). Occasionally an open procedure is needed. 

If the patient’s age at the time of the first shoulder dislocation is below 20 years, then there is a 70 to 90% chance that it can recur again based on their sporting activities. Any shoulder dislocation can reoccur within the first two years of the first dislocation. If the patient’s age at the time of first dislocation is over 40, then re-dislocation chances are less, which is again dependent on the usage of the arm.

Myth 2: Only an open surgery can stabilise the shoulder after a dislocation

Fact: There are two types of shoulder surgery; doctors usually prefer minimally invasive arthroscopic keyhole surgery.

Arthroscopic Shoulder Surgery: In an arthroscopic technique, the shoulder surgeon accesses the shoulder using tiny incisions to minimise damage to surrounding tissues. The patient is given general anaesthesia. A slim, pencil-sized instrument called an arthroscope is inserted into the joint through a small incision, and there is a video camera and a light at one end, which sends a live video of the inside of the shoulder to a nearby monitor. After getting a clear view of the insides of the shoulder, the surgeon inserts miniature surgical tools through a separate small incision. Under the guidance of the video, the surgeon repositions a torn ligament or labrum to the bone.

Open Shoulder Surgery is preferred when even after arthroscopic surgery, weakness or pain persists or if the shape of the bones in the joint changes. In open surgery, the surgeon accesses the joint through a single incision above the shoulder joint. The surgeon will then repair the damaged part of the joint.

Myth 3: Since I had surgery, I can return to normal activities faster than with non-surgical treatments

Fact: Shoulder dislocation recovery takes time to heal based on the severity of the surgery and the physical therapy following the surgery. On average, the patient has to wear a sling 4 to 6 weeks after surgery, and it can be removed only for bathing, dressing, or performing arm exercises. Sleeping is another activity that is affected after surgery. So sleeping in a recliner with a pillow behind the affected arm is better. Ice therapy should be done for 10 to 15 minutes several times daily to reduce pain and inflammation. Once the patient gets clearance from the surgeon and the physical therapist, they should start exercising.

Myth 4: Physical therapy is not needed if surgery has been performed

Fact: About 2 weeks after surgery, patients should begin extensive stretching exercises. For the first six weeks, gentle motions are suggested to increase the range of motion and flexibility. Later on, you move towards resistance and strengthening exercises. Full regaining of the strength and activity may take up to a year. If the patient fully follows their rehabilitation plan and protects the shoulder can anticipate a total return to pre-injury action.

Myth 5: I have to stop my sporting activities after a shoulder dislocation 

Fact: Before starting to play, consult your physician about clearance to return to play. Postpone golfing or swimming for about 6 weeks. Still, high-impact sports that can affect the shoulder, such as football or volleyball, require several months of rehabilitation before individuals can resume playing.

We at Hyderabad Shoulder Clinic give you complete information before deciding on surgery. We carefully analyse every aspect of your injury, medical history, and any previous dislocations. For more information, visit our website Orthopedic Hospital in Hyderabad | Orthopedic Surgery | Dr Chandrashekar (hyderabadshoulderclinic.com), or contact us at +91 9959588389, shoulderandsportsclinic@gmail.com.