Anterior Shoulder Dislocation CaloundraFebruary 1, 2012
Anterior dislocation of the shoulder is the most common method of shoulder dislocation. It often occurs when the shoulder is in extreme ranges of abduction and external rotation such as when tackling in rugby or falling onto your outstretched hand. There is often a sudden onset of shoulder pain with a feeling of the shoulder popping out. If the shoulder joint remains dislocated after the initial injury, there will be a deformity of the joint such that there is a bulge at the front of the shoulder with a sulcus (depression) above it.
Relocation of the shoulder joint should be carried out as soon as possible but it is important that this is done by an appropriately trained medical professional.
Following relocation and recovery from the acute pain of the dislocation, there are two options for treatment of a dislocation. If there has been damage to any of the internal structures of the shoulder, such as the labrum (cartilage ring surrounding the “cup” of the shoulder joint) or the bony cup itself (the glenoid), then surgery is often required. Damage to these structures can be identified arthroscopically or by x-ray and MRI imaging. If no damage is identified then conservative management is possible and often includes physiotherapy to strengthen the shoulder internal rotators and minimise the chances of recurrent dislocation. In the younger athlete, surgical intervention should always be considered as the rate of dislocation without it is high. If surgery is chosen, post-surgical physiotherapy is required to restore normal range and develop optimal shoulder strength to protect against future incidents.