Dr Bryan Betty: Dislocated shoulders

This week Chris Woakes the English cricket batting star dislocated his shoulder in the England-India test, then yesterday came out to bat with a dislocated shoulder at number 11 to try and save the test! Very brave stuff!

What is a shoulder dislocation?

• The shoulder is the most mobile joint in the body.
• It’s a ‘ball and socket’ joint, however sockets aren’t deep enough so the joint is supported by tendons and muscles.
• Occasionally the ball can come completely out of the socket – a dislocation.
• It can dislocate forward, which is common, or backwards, which is less common.

How do they happen and what are the signs?

• Generally an accident that puts severe force on the shoulder can cause dislocation.
• For example:
  • Falling from ladder and holding on it.
  • Collision in sport or falling onto an outstretched arm.
  • Car accidents.
• Some people have very flexible shoulders and can dislocate with simple things like rolling over in bed, hanging out washing.
• Effects: severe pain, unable to move the shoulder, occasional numbness down arm.
• You can see the deformity – can see the ball out of the socket, bulging out.

What do we do about it?

• See a doctor who will examine the shoulder.
• An Xray to make sure it is not broken.
• Then pop it back into place with light sedation or anaesthetic.
• Then keep the arm in a sling for 1-2 weeks, avoiding lifting or using the shoulder for six weeks. It can take up to 3-4 months to fully heal.
• Physio is often important to strengthen the shoulder and get moving.

Are there any complications?

• You can fracture the shoulder.
• Can tear cartilage (or lining) of the shoulder.
• Sometimes the tendons and muscles supporting the shoulder tear – call this a rotator cuff tear.
• Nerve damage can occur.
• Sometimes requires surgery.
• Can become recurrent and requires surgery to stop it popping out: orthopaedic surgeon.

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