Expertise in managing recurring injury
The shoulder is the most mobile joint in the body. With its impressive range of movement, it becomes prone to dislocation and resultant instability. This is especially common with contact sports injuries or with trauma from an accident.
Initially, shoulder dislocations are often treated by a GP or in the emergency department. Depending on a range of clinical factors, your GP can refer you to Dr Ward for assessment, further investigation and possible treatment to get you on the road to recovery. A shoulder dislocation can lead to ongoing shoulder instability.
Signs and symptoms
Shoulder dislocations and shoulder instability have similar symptoms.
They can include:
Shoulder dislocation symptoms
- Intense pain
You will often not be able to move your shoulder at all due to pain. Muscle spasm after shoulder dislocation is also very common and causes an increase in pain. - Deformity
A dislocation takes the joint out of its regular position, which may appear as a hard lump at the front of your shoulder. - Swelling and bruising
Swelling will develop quickly with bruising developing in the following hours or days. - Numbness and tingling
Numbness and tingling in the arm is commonly associated with dislocation. These symptoms usually disappear once the joint is put back into place.
Shoulder instability symptoms
- Recurring shoulder dislocations
Previous injury may disrupt the normal structures that hold the shoulder in place, making it prone to future dislocation. - A ‘loose’ feeling
Your shoulder may feel as though it slips in and out of joint, or is just hanging in place. Your shoulder may ‘give out’ during activities. - Weakness
You may have less strength in your shoulder and arm and feel as though you cannot do certain actions without hurting yourself.
Diagnosing shoulder dislocation and instability
Shoulder dislocation is typically diagnosed through an examination. Your doctor will examine your injured shoulder for deformities and ask how the injury occurred. The physical exam is generally enough to diagnose a dislocation on its own, though your doctor will also request an x-rays or other scan to check for any accompanying injuries.
Associated injuries, such as ligament or cartilage tears, can lead to ongoing shoulder instability after recovery from the initial dislocation. Your doctor will usually identify shoulder instability by asking about your symptoms and doing a physical examination. The diagnosis can be confirmed with x-rays, MRI and sometimes ultrasound to identify any damaged structures within the shoulder.
Treating shoulder dislocations and instability
An initial dislocation should be treated as soon as possible after it happens. This may be done by a doctor in the emergency room or by and experienced trainer or paramedic in the field. This is generally done with a manoeuvre called a closed reduction. This puts the shoulder joint back in place and typically will relieve severe pain almost immediately. Your arm is initially immobilised in a sling or brace before further assessment.
Up to 95% of shoulder dislocations can lead to recurring shoulder instability. The younger the patient, the higher the chance of ongoing instability. Ongoing care may involve initially wearing a shoulder brace to support the injured shoulder, or avoiding certain activities to prevent the shoulder from dislocating again. Physiotherapy is recommended to strengthen the shoulder and support the shoulder joint.
Surgery may be recommended if non-operative treatments cannot adequately reduce your shoulder instability. This usually involves identifying and treating underlying injuries – such as Bankart lesions, rotator cuff tears, or weakened shoulder ligaments. Dr Jason Ward can perform repairs to these structures using arthroscopic methods, leaving minimal scarring and allowing timely return to normal activity.
Adelaide shoulder instability management
Dr Jason Ward provides conservative and surgical treatments for shoulder instability and dislocation from his clinics across Adelaide and regional South Australia. Contact his rooms to book an orthopaedic consultation.
