Shoulder dislocation occurs when the humeral head (the ball-shaped bone at the top of the upper arm) is forced out of the shoulder socket. It is a common injury that can occur in people of all ages, but it is more common in young adults and athletes who participate in contact sports. In this blog, we will discuss the causes, symptoms, treatment, surgeries involved, duration of hospital stay, and recovery time associated with shoulder dislocation.
Shoulder dislocation can occur due to a variety of reasons, including sports injuries, falls, and accidents. The most common cause of shoulder dislocation is a traumatic injury to the shoulder joint, such as a fall or a direct blow to the shoulder. In some cases, shoulder dislocation can also be caused by repetitive strain injuries or overuse injuries.
Dislocated shoulder symptoms can include
The treatment for shoulder dislocation depends on the severity of the injury. In most cases, the doctor will first try to reset the shoulder joint back into its socket. This is called closed reduction and is often performed under sedation or anesthesia. After the shoulder has been reset, the doctor may recommend immobilizing the shoulder joint in a sling or brace for several weeks to allow the injured tissues to heal.
Usually no surgery is necessary, especially if the shoulder was dislocated for the first time. The doctor may determine that surgery is needed if bones or tendons are injured. If the shoulder is dislocated more than once, which is more common among young athletes, doctors might surgically repair or tighten ligaments that keep the arm bone connected to the shoulder blade.
If the shoulder dislocation is severe or if it keeps recurring, surgery may be required. There are several surgical procedures that may be used to treat shoulder dislocation, including Bankart repair, Latarjet procedure, and arthroscopic surgery. The type of surgery that is recommended will depend on the individual case and the underlying cause of the dislocation.
Bankart repair surgery is a surgical procedure used to treat shoulder instability caused by a Bankart lesion, which is a tear or detachment of the labrum from the front of the shoulder socket (glenoid). The labrum is a ring of cartilage that helps stabilize the shoulder joint.
During the surgery, the surgeon will make a small incision in the front of the shoulder and reattach the torn labrum to the glenoid using sutures and anchors. This procedure may be performed using arthroscopic or open surgical techniques, depending on the severity of the injury and the surgeon's preference.
Duration of Hospital Stay : The patient may need to stay in the hospital for a day or two after the surgery. The recovery time for Bankart repair surgery can vary, but most patients can expect to return to normal activities within 3-6 months after the surgery.
The Latarjet procedure is a surgical technique used to treat recurrent shoulder dislocations, which occur when the humeral head (ball of the shoulder joint) comes out of its socket. The procedure involves transferring a piece of bone with attached tendons from the coracoid process (a bony structure in the shoulder blade) to the front of the glenoid (the socket of the shoulder joint), in order to stabilize the joint.
The procedure is typically performed under general anesthesia and requires an incision in the front of the shoulder. The surgeon will detach the coracoid process from the scapula and transfer it to the glenoid, where it is fixed in place with screws. The tendons attached to the coracoid process are also reattached to the humerus (upper arm bone) to provide additional stability.
Duration of Hospital Stay : The patient may need to stay in the hospital for 2-3 days after the surgery. The recovery time for the Latarjet procedure can vary, but most patients can expect to return to normal activities within 4-6 months after the surgery.
Arthroscopic surgery is a minimally invasive surgical procedure that is used to treat various shoulder injuries, including shoulder dislocation. It involves making a small incision in the skin and inserting a tiny camera, called an arthroscope, into the shoulder joint. The arthroscope allows the surgeon to see inside the joint and repair or remove damaged tissue.
Arthroscopic surgery can be used to repair tears in the labrum or rotator cuff, remove bone spurs, and treat other shoulder injuries. It is a less invasive option than traditional open surgery and can lead to less pain, scarring, and a quicker recovery time.
Duration of Hospital Stay : The patient can usually go home on the same day as the surgery, or in some cases, may need to stay overnight for observation. The recovery time for arthroscopic surgery can vary depending on the patient's overall health. However, most patients can expect to return to normal activities within 3-6 months after the surgery.
A rotator cuff tear is a condition in which one or more of the tendons that make up the rotator cuff in the shoulder become damaged or torn. The rotator cuff is a group of muscles and tendons that attach the upper arm bone to the shoulder blade and help to provide stability and mobility to the shoulder joint. Rotator cuff tears can cause pain, weakness, and limited range of motion in the affected shoulder.
Types of torn rotator cuffs include
With an incomplete or partial tear, the tendon still somewhat attaches to the arm bone.
With a full-thickness or complete tear, the tendon separates completely from the bone. There’s a hole or rip in the tendon.
Rotator cuff tears can be caused by various factors, including
Repetitive overhead motions can lead to wear and tear of the rotator cuff tendons, eventually causing a tear.
A fall on an outstretched hand or a direct blow to the shoulder can cause a rotator cuff tear.
As we age, our tendons lose their elasticity and become more prone to injury. This degeneration can lead to a rotator cuff tear.
The symptoms of a rotator cuff tear may vary depending on the severity of the tear. Some common symptoms include
Pain in the shoulder or upper arm is a common symptom of a rotator cuff tear.
Weakness in the shoulder or arm can make it difficult to perform daily activities.
Reduced mobility in the shoulder joint can make it difficult to reach or lift objects. Such as difficulty in combing your hair or reaching behind your back
Sleeping on the affected shoulder can cause pain and discomfort.
The treatment for a rotator cuff tear may vary depending on the severity of the tear. Some common treatment options include
Resting the shoulder and avoiding activities that cause pain or discomfort can help promote healing.
Specific exercises can help strengthen the muscles around the rotator cuff and improve range of motion.
Over-the-counter pain relievers or prescription medications can help manage pain and inflammation.
Corticosteroid injections can help reduce inflammation and pain in the shoulder.
In some cases, surgery may be necessary to repair a rotator cuff tear. There are several surgical options, including
During arthroscopy, your surgeon inserts a small camera, called an arthroscope, into your shoulder joint. The camera displays a live video feed on a monitor, and your surgeon uses these images to guide miniature surgical instruments.During arthroscopy, your surgeon can see the structures of your shoulder in great detail on a video monitor.
Because the arthroscope and surgical instruments are small and thin, your surgeon can use very small incisions (portals), rather than the larger incision needed for standard, open surgery.
Arthroscopic repair is usually an outpatient procedure and is the least invasive method to repair a torn rotator cuff.
A more invasive procedure that involves making a larger incision to repair the tear. A traditional open surgical incision (several centimeters long) is often required if the tear is large or complex. The surgeon makes the incision over the shoulder and detaches or splits part one of the shoulder muscles (deltoid) to better see and gain access to the torn tendon.
During an open repair, the surgeon typically removes bone spurs from the underside of the acromion (this procedure is called an acromioplasty). An open repair may be a good option if the tear is extensive or intricate and requires additional reconstruction, such as a tendon transfer.
When a rotator cuff tendon is too damaged or retracted to be repaired through traditional methods, a tendon transfer procedure may be considered as an alternative. This surgery involves taking a healthy tendon from another part of the body, usually a nearby muscle, and attaching it to the bone in place of the damaged or torn tendon.
During the surgery, the surgeon will first identify a suitable tendon that can be transferred and then detach it from its original attachment point. The tendon is then carefully rerouted and reattached to the bone using sutures or small metal anchors. The transferred tendon will eventually heal and take on the function of the original torn tendon, helping to restore strength and stability to the shoulder joint.
In summary, a rotator cuff tear can cause significant discomfort and impair shoulder function. Overuse and injury are the most common causes. While treatment options like rest, physical therapy, medications, and injections can help in some cases, severe tears may require surgery. If you're experiencing any symptoms of a rotator cuff tear, seeking medical attention as soon as possible is crucial for an accurate diagnosis and to determine the best treatment plan to restore shoulder function and alleviate pain.
Shoulder impingement syndrome is a common cause of shoulder pain. It occurs when there is impingement of tendons or bursa in the shoulder from bones of the shoulder. It is the result of a vicious cycle of rubbing of the rotator cuff between your humerus and top outer edge of your shoulder. The rubbing leads to more swelling and further narrowing of the space, which result in pain and irritation.
With impingement syndrome, pain is persistent and affects everyday activities. Motions such as reaching up behind the back or reaching up overhead to put on a coat or blouse, for example, may cause pain.
Over time, impingement syndrome can lead to inflammation of the rotator cuff tendons (tendinitis) and bursa (bursitis). If not treated appropriately, the rotator cuff tendons can start to thin and tear.
Impingement syndrome can be caused by a variety of factors, including
Repetitive overhead activities such as throwing, swimming, or lifting can cause impingement syndrome.
Certain anatomical features of the shoulder, such as a hooked acromion or a downward sloping acromion, can contribute to impingement syndrome.
Weakness in the muscles of the rotator cuff or scapular stabilizers can lead to impingement syndrome.
Instability in the shoulder joint can cause impingement syndrome.
A fall or other trauma to the shoulder can cause impingement syndrome.
The symptoms of impingement syndrome can vary in severity and may include
Treatment for impingement syndrome typically involves a combination of non-surgical and surgical options.
Arthroscopic surgery is a minimally invasive procedure that involves inserting a small camera and surgical instruments through small incisions in the shoulder to remove any bone spurs or other obstructions that are causing impingement. This procedure is often preferred over open surgery as it typically involves less pain, shorter recovery time, and fewer complications.
Duration of Hospital Stay : Most patients are able to go home the same day or the following day after the surgery. However, some patients may require a longer hospital stay depending on their individual circumstances. The recovery time generally takes between one and four months.
Open surgery may be necessary in cases where the impingement is caused by damaged tendons or other soft tissue structures in the shoulder. During open surgery, the surgeon makes a larger incision in the shoulder to repair or replace the damaged tissues. This procedure may be more invasive than arthroscopic surgery and may require a longer recovery time.
Duration of Hospital Stay : In general, patients are required to stay in hospital for about 1-2 days. Approximately the recovery time generally takes about 6 months.
Shoulder replacement surgery may be recommended in cases where the joint has been severely damaged due to impingement syndrome. This procedure involves replacing the damaged joint with an artificial joint or prosthesis. Shoulder replacement surgery is typically reserved for severe cases where other treatment options have failed, and the patient is experiencing significant pain and loss of function in the shoulder joint.
Duration of Hospital Stay : In general, patients are required to stay in hospital for about 2-3 days. Patients can continue their daily activities after a few weeks but full recovery requires about 4 months.
Prevention of impingement syndrome involves maintaining good shoulder health and avoiding activities that put excessive strain on the shoulder joint. This can be accomplished through
Frozen shoulder syndrome is a rare condition involving the thickening and contracting of the muscles surrounding the shoulder joint. It's characterized by the inability to move the shoulder and may cause shoulder pain. Frozen shoulder results from the gradual loss of movement in the shoulder (glenohumeral) joint. This joint consists of a ball (the humeral head) and socket (the glenoid). Normally it is one of the most mobile joints in the body. When the shoulder is frozen, the joint has become stuck and its movement is limited.
This type occurs when a patient gradually experiences a slow loss of shoulder motion for no apparent reason. Possible causes include an inflammatory disease, changes in hormone levels or changes in the immune system. It may often be associated with diabetes or other endocrine disorders such as hypothyroid.
This type occurs from a known cause such as following a shoulder injury, shoulder fracture or previous shoulder surgery.
Frozen shoulder often occurs in three stages
Freezing stage involves a slow progression of shoulder stiffness and pain. The shoulder begins to lose motion as pain progresses. This stage can span from six weeks to nine months.
Frozen Stage features an improvement in pain levels, but stiffness persists. This stage may last between four and nine months.
Thawing stage occurs when the shoulder motion gradually returns to a normal state of functioning. This stage can take anywhere from five to 26 months.
It is not known exactly what causes this condition. Immobilization of the shoulder (after an arm injury, for instance) can lead to frozen shoulder. Inflammation of the muscles and/or tendons, as with rotator cuff tendinitis or bursitis, can also cause the shoulder joint to become frozen.
Age and gender are both risk factors for frozen shoulder. Those between the ages of 40 and 60 are more likely to get frozen shoulder. It's also more common in women.
Others at risk for frozen shoulder include those with pre-existing conditions like
The symptoms of frozen shoulder usually develop gradually and can last for several months to years. They include
Physical therapy is an effective treatment option for frozen shoulder. It involves exercises and stretches to help improve the range of motion and flexibility of the shoulder joint.
Over-the-counter pain medications like ibuprofen or acetaminophen can help reduce pain and inflammation associated with frozen shoulder. Your doctor may also prescribe corticosteroids to reduce inflammation.
Injections of corticosteroids or numbing medications directly into the shoulder joint can help reduce pain and inflammation.
If your symptoms are not relieved by other nonsurgical methods, your doctor may recommend hydrodilatation. This procedure involves gently injecting a large volume of sterile fluid into the shoulder joint to expand and stretch the shoulder joint capsule. Hydrodilatation is conducted by a radiologist who uses imaging to guide the placement of fluid.
Performed less commonly since arthroscopic treatment options became common, a manipulation under anesthesia (MUA) is essentially the passive stretching of your shoulder while you're asleep. Often an MUA is performed in conjunction with an arthroscopic capsular release.
Surgery for frozen shoulder is rare. But if nothing else helps, surgery can remove scar tissue from inside the shoulder joint.
Arthroscopic capsular release is a minimally invasive procedure that involves making small incisions in the shoulder and using a small camera and instruments to cut through the tight capsule and release the adhesions. The camera allows the surgeon to see inside the joint and guide the instruments to the right location. This procedure is typically performed under general anesthesia and usually takes less than an hour to complete. The goal of Arthroscopic capsular release surgery is to cut through the tightened capsule and release the adhesions, allowing for greater range of motion and decreased pain.
Duration of Hospital Stay : The duration of hospital stay for arthroscopic capsular release surgery is typically short, often requiring only an overnight stay or even a same-day discharge, depending on the individual's condition. Recovery time is usually short, and patients are often able to return to normal activities within a few weeks.
Open capsular release is a more invasive surgery that involves making a larger incision in the shoulder and cutting through the capsule to release the adhesions. This procedure is typically performed under general anesthesia and may take longer to recover from than arthroscopic capsular release. However, it may be necessary if the adhesions are particularly severe or if the surgeon needs to repair other structures within the shoulder joints. Open capsular release surgery aims to release the adhesions and cut through the tight capsule surrounding the joint, which in turn improves the range of motion and reduces pain in the shoulder.
Duration of Hospital Stay : Patients may be required to stay 1-2 nights in the hospital. It may take several weeks to months to fully recover and regain strength and range of motion in the affected shoulder.