Your shoulder joints are one of the easiest joints to dislocate, and shoulder pain in general can have a significant negative effect on your life.
While there are multiple forms of shoulder joint dislocation, shoulder subluxation is one of the more common. A partial dislocation of the shoulder joint, subluxation occurs when the head of the humerus (the arm bone) is partially pulled out of the glenoid (the socket).
When you dislocate your shoulder completely, the head of the upper arm bone or humerus comes completely out of the socket, but during a shoulder subluxation, the head of the arm only comes part of the way out of the socket.
Your humerus or arm bone can shift forward, backward, or downward during a shoulder subluxation; you can also experience tearing of the muscles, ligaments, or tendons around the shoulder joint.
You should know that your shoulder is one of the easiest joints to dislocate or damage due its mobility – the same mobility that lets you swing your arms around, throw a basketball or baseball pitch, lift weights, and generally use your shoulders in the way you’d expect, particularly if you are an athlete.
When you swing your arms too forcefully or rapidly (like when you’re throwing a ball underhand or overhand), this can cause your shoulder joint to sublux; shoulder subluxation can also happen after prolonged periods of similar movements (e.g. being a baseball pitcher, AFL or rugby player).
How do you know you’ve experienced a shoulder subluxation?
This type of injury causes pain, swelling, weakness, and a sort of numbness or “pins and needles” feeling in your arm. Know that with a subluxation, your arm bone may pop right back into your shoulder socket or glenoid by itself, but you should still see a doctor to make sure everything is situated and healing properly.
Shoulder joint subluxation and shoulder joint dislocation have similar symptoms, so the best way to make sure everything is okay is to be checked out by a doctor.
If you think that you’ve experienced shoulder subluxation or that your shoulder joint is out of place, you should seek medical attention as soon as possible, and never try to put your joint back in place by itself, since you can potentially injure ligaments, muscles, and other tissues around your shoulder.
Your doctor will likely order X-Rays in order to see if the head of your arm bone has come totally or partially out of the socket along with performing a physical before officially diagnosing your shoulder injury.
This will also help them to see if there are other fractures or injuries in your shoulder area. Then they will likely put your shoulder joint back into place and develop a care plan for you.
There are several other types of shoulder injuries that appear similar to shoulder joint subluxations, including collarbone injuries, rotator cuff injuries, biceps tendinopathy, full shoulder dislocations, and swimmer’s shoulder.
This is one of the many reasons why that if you experience a shoulder injury and/or severe shoulder pain, it’s important to see a doctor with expertise in this specific area as soon as possible.
People often confuse a shoulder dislocation – which tends to occur during a more catastrophic moment like an accident or a fall (when you’re putting your arms out to protect yourself or a direct blow to the shoulder area) – with shoulder subluxation – which is more common with repeated stress from activities like overhand throws or swings.
That said, pain, weakness, and numbness in the shoulder are the common symptoms of both types of injuries, paired with a feeling that your shoulder has gone in and out of place.
Treating a shoulder subluxation
Of course, the first step is making sure your shoulder joint is back in place where it should be – which is something you should generally wait for a doctor to do, although at times it might be recommended for treatment to occur on the field, at the gym, or wherever else your injury occurred if the paramedics or medical staff deem that to be necessary.
Once you’ve subluxed your shoulder for the first time, it’s more likely to happen again, which is why it is so important that you see a qualified orthopaedic surgeon immediately and determine the best course of treatment, even if the original injury does not seem particularly severe.
Closed reduction procedures for shoulder subluxation
One way to treat shoulder subluxation is with a closed reduction, which involves moving the shoulder back into place by rotating and moving the arm until the humerus slides back into the glenoid, or to put it more plainly, your arm bone is back into its socket.
This can be a painful process so your doctor will likely give you pain medication beforehand, or even a general anesthetic. X-Rays will be done afterwards to make sure your shoulder joint is in the correct position and that you have no other injuries that need to be addressed.
Once your shoulder joint is back in place, much of your pain should be relieved. Pain relief medication may be prescribed afterwards as well; if your pain persists, do not hesitate to go to your doctor for further treatment.
Afterwards, you’ll need to wear a sling for a couple weeks in order to keep your shoulder in place and your joint relatively still. This prevents the bone from slipping out again and helps you to keep from stretching or moving it too much until your shoulder subluxation heals.
Shoulder subluxation surgery
If you regularly experience shoulder joint subluxation, you may require surgery to fix the issues that are making your shoulder joint unstable. Problems like ligament tears, tears in the socket, fractures of the glenoid socket or the head of your humerus, or rotator cuff tears can all cause repeated subluxations that need surgical intervention.
This is typically performed with very small incisions, which is referred to as an arthroscopy or arthroscopic shoulder surgery. Depending on the extent of the injury, a more complex procedure or reconstruction may be required, this is called an arthrotomy.
Either way, rehab and physical therapy will be recommended post-surgery in order to make sure your shoulder heals properly. It’ll likely take about four to six weeks after surgery for you to resume normal activities, and athletes should know that they won’t be able to fully participate in their sport(s) of choice for several months after their shoulder surgery.
Rehabbing and healing after a shoulder subluxation
After you’ve had surgery or other treatment for a shoulder subluxation and you are done with the sling (as per your doctor’s orders), you’ll need physical therapy / physiotherapy to strengthen the damaged joint and get your full range of movement back (or at least as much as possible). These are gentle and low impact exercises that help to stabilize your shoulder joint.
Some techniques that your physical therapist will use include joint mobilizations (moving the shoulder joint through a series of positions that are meant to improve rotation and flexibility), therapeutic massage, ultrasound treatments, icing the joint, applying heat to the joint, stability exercises, and strengthening exercises.
The types of movements that you do will be regular and gentle, aimed at preventing your shoulder from getting stiff while stretching the muscles in a natural way.
Kinesio taping or K-taping for shoulder subluxations may also be recommended depending on your injury; ask your doctor and physiotherapist / physical therapist about this process.
You will likely also be assigned an exercise regimen to perform at home on a regular basis during recovery from your shoulder subluxation; of course, you should follow your surgeon’s and physical therapist’s advice and avoid other activities and sports that might cause you to aggravate the injury or otherwise impede the healing process.
Ease back into sports and other everyday activities slowly and when you feel ready.
It’s essential to understand that once you’ve subluxed your shoulder joint, it’s more likely to happen again in the future, so being realistic about your capabilities and following the advice of your doctor and physical therapists is one of the most important aspects of the healing process.
Your surgeon or shoulder specialist should connect you with a physiotherapist / physical therapist if they don’t already have one in their practice or in-house.
What are some of the future complications that occur after a shoulder subluxation?
We’ve already noted that once you sublux your shoulder once, it’s much more likely to happen again in the future, especially if you don’t go through the whole treatment and healing process. If you start experiencing shoulder subluxations regularly, you may have to undergo surgery to treat the problem.
Shoulder instability, loss of movement, loss of flexibility, and other injuries to your ligaments, muscles, and tendons can happen as a result of shoulder subluxation, along with nerve or blood vessel damage.
All of this is why if you suspect you have experienced a shoulder subluxation, you should see an orthopaedic surgeon who specializes in these types of injuries as soon as possible in order to mitigate the long-term damage.