About your shoulder

The shoulder is the most mobile joint in your body. Its wide range of motion also makes the shoulder joint less stable than other joints. Researchers estimate that shoulder dislocations make up 50 percent of all major joint dislocations.

A dislocated shoulder means that the head of the arm bone has popped out of the socket of the shoulder blade. A dislocation may be partial or complete. Forward dislocation happens in 95 percent of cases. Backward or downward dislocations can also happen.

A forward dislocation can happen when the arm is hit while stretched or pulled back — for example, when throwing a ball or reaching for something. A strong blow to the arm by a fall, collision, or force (like in a car accident) can also dislocate the shoulder.

Any type of dislocation will cause pain in your shoulder.

An impact that can cause a dislocation will likely also injure other parts of your shoulder. There may be damage or tears to the muscles, blood vessels, ligaments and tendons, and nerves. The arm bones may have fractures, or you may have internal bleeding in the shoulder and arm.

If you have a dislocated shoulder, you may experience:

  • intense or throbbing pain
  • the inability to move the joint or arm
  • swelling in the shoulder or beyond that area
  • weakness and numbness in the shoulder, arm, and hand
  • bruising around the area and down the arm
  • a deformity (the shoulder being visibly out of place)
  • tingling down the arm or in the neck

Long-term (chronic) pain can also be a sign of inflammation in the shoulder. This can happen if the dislocation is from wear-and-tear, an old injury, or arthritis in the joint.

If you have a dislocated shoulder, don’t move it or try to push the joint back in because this can damage the muscles, blood vessels, nerves, ligaments, or cartilage in the shoulder. If the dislocation is caused by a fall or similar injury, there may be other damage, broken bones, or torn muscles. Trying to pop your shoulder back in can worsen this damage.

Instead, seek medical attention immediately.

While you wait, you can stabilize your shoulder with a sling or splint. Alternatively, tape or tie the arm of your injured shoulder to your body. Apply ice to help ease the pain and bring down swelling. Get tips on icing your injury.

A medical professional can gently push the upper arm bone back into the socket joint. The medical term for this is a closed reduction. Pain medication or a sedative is sometimes given before this is done.

The American Red Cross provides guidelines for safely moving your shoulder back into place. This is for extreme situations or when you’re isolated and several hours from help. This should only be done if the pain is manageable.

See a doctor as soon as you can, even if the shoulder pops back in.

The Stimson technique

This technique needs the help of a second person.

  1. Lie face down on a hard, raised surface, such as a table or a log.
  2. Relax and let the arm on the dislocated side hang straight down.
  3. Have the other person tie a heavy object that weighs about 5 to 10 pounds to your wrist. This could be a large water bottle or a backpack. The weight and gravity should reposition the ball of your arm bone back toward the socket. The shoulder should “pop” back in.
  4. After 20 minutes, remove the weights.

The important part of this technique is to allow your muscles to relax back into place. If the muscles aren’t relaxed, the shoulder won’t pop back into its socket.

Alternatively, the second person can use similar traction as weights by holding your wrist and applying consistent downward pressure for 10 to 20 minutes.

Popping the shoulder joint in yourself

The Red Cross recommends this technique if you’re alone and unable to get help. You’ll need a sling to put your arm in. You can make a sling out of a piece of clothing or a towel.

  1. While standing or sitting, grab the wrist of your injured arm.
  2. Pull your arm forward and straight, in front of you. This is meant to guide the ball of your arm bone back to the shoulder socket.
  3. When the shoulder is back in place, put your arm in the sling.
Tips

Move slowly and firmly. It’s about traction and slow movement, not jerking or yanking the arm.

FARES method

The FARES method, which stands for FAst, REliable and Safe, typically takes about two minutes to perform. It requires a second person to help you.

  1. Lie on your back.
  2. The other person stands beside you on the side of your injured shoulder. Holding your wrist with both hands, they need to keep your arm straight and level with your body, with your forearm and hand facing downward.
  3. Starting with your arm at your side, they slowly move your arm toward your head while also making a small circular or up-and-down movement. This is a gentle but firm pumping motion of about 2.5 inches up and down.
  4. The other person continues until your injured arm is at the height of your shoulder, making a 90-degree angle with your body. At this point, they begin to rotate your arm in place.
  5. They then move your arm closer to your head, but only until it’s at about a 120 degree angle, while slightly rotating the arm. If the technique was effective, your shoulder joint should now be in place.
  6. The other person finishes by bending your arm at the elbow and securing your arm close to your body using a sling or tape.

If you have a dislocated shoulder, an emergency room doctor can repair the joint. An orthopedic surgeon (bone specialist) may examine your shoulder to make sure the joint is stable. A general or vascular surgeon may also be needed if there is damage to the blood vessels or other tissues in your shoulder.

A sports doctor and physiotherapist can provide guidance on how to strengthen the joint. Additionally, your family doctor can check your shoulder regularly, prescribe medications as necessary, and refer you to a specialist if you need to see one.

You will need further care and treatment as the joint heals. This could include:

  • anti-inflammatory medication
  • heat or cold therapy
  • muscle relaxers
  • pain medication
  • physical therapy with muscle toning exercises
  • surgery to repair or tighten any torn or stretched muscles and ligaments
  • surgery if there is bone damage in the area
  • wearing a brace
  • wearing a sling to keep your arm and shoulder still

A dislocated shoulder will take up to 16 weeks to heal after it has been pushed back into place. During this time, you must limit movement and shouldn’t carry anything heavy.

If you’ve had a dislocated shoulder, it can occur again especially if you are younger than 25 or older than 40 years. Athletes and people with physically demanding jobs are also at higher risk.

You can help stabilize the shoulder joint with at-home exercises. Stretching exercises help keep the rotator cuff and other muscles flexible. The American Academy of Orthopedic Surgeons recommends these simple stretches to condition the shoulder:

Crossover arm stretch

  1. Relax your shoulders while standing or sitting.
  2. Gently stretch one arm across your chest as far as possible.
  3. Use your other hand to help hold your arm up without pulling or putting any pressure on the elbow.
  4. Hold the stretch for 30 seconds, relax, and repeat with the other arm.
  5. Exercise each arm four times, five or six days a week.

Pendulum stretch

  1. Stand at a table or counter with one hand on it for support.
  2. Lean forward and let your free arm hang limply at your side.
  3. Gently swing your arm forward and back, side to side, and in a circular motion.
  4. Repeat the motion with your other arm.
  5. Do this exercise in two sets of 10, five to six days a week.

Scapula setting

  1. Stand up straight or lie on your stomach with your arms at your sides.
  2. Gently pull your shoulder blades together and down as much as possible.
  3. Return about halfway to the resting position and hold for 10 seconds.
  4. Relax completely.
  5. Repeat the stretch 10 times, three times a week.

Shoulder strength exercises

Your doctor or physical therapist may recommend exercises for the shoulder. These toning exercises focus on the muscles of the rotator cuff, upper back, front of the shoulder, and upper arm.

Strengthening and stretching these muscles helps to keep the joint stable, relieve shoulder pain, and may prevent dislocations from recurring.

Muscle toning exercises include:

The shoulder joint is also called the glenohumeral joint. It’s a ball-and-socket joint that connects the shoulder blade (scapula) and the head of the upper arm bone (humerus). Both of these bones are covered in a layer of cartilage to reduce friction. The inside of the joint is lined with thin sacs of lubricating synovial fluid, similar to ball bearings in a wheel.

The socket part of the shoulder joint is shallow — think of a golf ball sitting on a tee. A collar of cartilage called the labrum rims the socket to help secure the “ball.” A fibrous casing covers the entire joint to help make it more stable.

The rotator cuff is made of four muscles that stabilize the shoulder joint while allowing motion. Four major ligaments and a number of tendons help to further stabilize the joint.

Although shoulder dislocations are common, they can be serious and always require professional medical care. It isn’t advisable to try to pop your own shoulder or push it back in.

If you have or have had a dislocated shoulder, talk to your doctor about the cause and how to prevent it from happening again. Take all medications as prescribed and see your doctor for follow-up appointments.

Warm up before exercising and stop immediately if you feel pain.

If you feel pressure, stiffness, or discomfort in your shoulder, stretching and strengthening exercises may improve overall joint health. A sports doctor or physical therapist can guide you on the safest way to do this.