Overview

A shoulder dislocation occurs when the upper arm bone (humerus) pops out of the shoulder socket (glenoid). The shoulder is the body’s most mobile joint, allowing for an extensive range of motion; unfortunately, this flexibility also makes it susceptible to dislocations.

In most cases, a dislocated shoulder is the result of a traumatic injury, from a fall, direct impact, or sports related accident.

If the inital injury is not properly treated, it can lead to recurrent dislocations and long-term shoulder instability and joint damage.

The good news is that with early intervention and the right treatment and rehabilitation, most people regain full function of their shoulder and have no longlasting issues.

Anatomy of the Shoulder

The shoulder is a ball-and-socket joint, where the humeral head (ball) fits into the glenoid (socket) of the scapula (shoulder blade). Unlike the hip joint, which is also a ball and socket joint, the shoulder is a much shallower joint which is why it is less stable.

The main structures that make up the joint are:

• Labrum – This is a ring of cartilage that help deepen the socket and adds stability.
• Ligaments – The ligaments join bone to bone and provide additional support, helping to prevent excessive movement.
• Rotator Cuff Muscles – These are a very important group of four muscles that work together in synergy to stabilise the shoulder, and allow smooth movement in all directions.

There are 3 different types of dislocations:

• Anterior dislocation: This is the most common – (95% of cases) – The humeral head moves forward out of the socket.
• Posterior dislocation: This is much more rare and is when the humeral head comes out backwards backward.
• Inferior dislocation: This is vary rare, and is almost always due to a very nasty trauma such as in a road traffic accident or high impact fall. In this case the humeral head is displaced downwards.

Causes of Shoulder Dislocation

Here are some of the most common causes of dislocation:

• Trauma or impact injuries – Falls, sports injuries, or car accidents.
• Repetitive overuse – Often seen in athletes (swimmers, gymnasts, tennis players).
• Joint hyperlaxity (loose joints) – Some people are naturally more prone to dislocations because their joints are too mobile.
• Previous dislocations – Once you have dislocated the shoulder, it is sometime more susceptible to future dislocations – especially if it has not been fully rehabvilitated and strengthened

Symptoms of a Dislocated Shoulder

Common symptoms include:

• Intense shoulder pain – you will experience immediate pain after the injury – this is much more intense if it is the first dislocation.
• Visible deformity – The shoulder may appear squared off instead of rounded.
• Inability to move the arm – you will not be able to move your arm without severe pain.
• Swelling and bruising – This will come on a few hours after the dislocation, and will likely be localised around the joint.
• Weakness or numbness – You may experience weakness, numbness or pins and needles in the arm, shoulder, or fingers due to nerves that can become squashed, trapped or over stretched.

Diagnosis

Physical Examination

A shoulder dislocation is fairly easy to diagnose due to the history of the injury and likely deformity of the shoulder. A specialist will assess arm position, swelling, and joint stability.

It is vital that you seek medical treatment as a matter of urgency, especially if it is a first time dislocation – the sooner you can get the shoulder relocated the better. However you should not attempt to relocate your shoulder without a skilled medical professional.

Imaging Tests

Often imaging will be done to confirm the diagnosis and also check for any other joint damage.

• X-rays – These might be used to confirm the shoulder has been relocated correctly and also to check for upper arm fractures.
• MRI or CT scan – These are used if soft tissue injuries (e.g., labrum or ligament tears) are suspected.

Treatment Options

Immediate Care: Relocating the Shoulder

As mentioned previously, a dislocated shoulder must be put back into place as soon as possible – a process called closed reduction.

• A doctor will gently manipulate the arm back into the socket.
• Strong pain relief and muscle relaxants will be used to ensure that you are comfortable throughout the procedure.
• You should feel Immediate pain relief once the shoulder is back in place, however you will likely have some residual soreness for a couple of weeks afterwards.

Non-Surgical Treatment (for first-time or mild cases)

After reduction, the initial management will include:

• Immobilisation – A sling is usually worn for 1-3 weeks to allow the joint and the soft tissues to heal.
• Pain relief – Anti-inflammatories (NSAIDs), and painkillers will be prescribed to help with the discomfort.
• Physiotherapy – This is absolutely vital in order to regain full function and prevent further dislocations. It will focus on strengthening the muscles around the shoulder and upper arm, as well as restoring movement and function.

Surgical Options for Shoulder Dislocation

In some circumstances surgery will be required. Your shoulder specialist will discuss this with you and ensure that you understand the process and the reason that surgery is the best option. Surgery is rarely the first line of treartment, but in some cases it is necessary.

This is usually because:

• Of recurrent dislocations
• There is significant labrum, ligament, or rotator cuff damage.
• These is a bone fracture as well as the shoulder dislocation.

Arthroscopic (Keyhole) Labrum Repair (Bankart Repair)

• Best for younger, active patients or those who have also sustained a labral tear.
• The torn labrum and ligaments are reattached to the socket using sutures and anchors.
• It is a minimally invasive proceedure, with small incisions and a quicker recovery time.
• The success rate is 85-90% in preventing future dislocations.

Latarjet Procedure (Bone Transfer Surgery)

• Used when there’s significant bone loss in the socket.
• A piece of bone (from the shoulder blade) is transferred to the front of the socket.
• It provides long-term stability for patients with chronic instability.
• Success rate: 90-95%.

Open Shoulder Stabilisation Surgery

• Recommended for severe cases where soft tissues are badly damaged.
• More invasive but offers excellent long-term stability.

Recovery & Outcomes

Non-surgical recovery

4-6 weeks with physiotherapy.

Post-surgery recovery

• 3-4 weeks in a sling.
• Physiotherapy starts early to restore motion.
• Full return to sports: 4-6 months for contact sports, 3 months for non-contact activities.

Success rates:

• 85-95% return to normal function with surgery.
• Physiotherapy alone is effective for many first-time dislocations.

Expert Shoulder Care at London Bridge Orthopaedics

If you’ve dislocated your shoulder, our shoulder team at London Bridge Orthopaedics provides specialist diagnosis, personalised treatment plans, and expert surgical care. Book a consultation today to discuss your options.

Questions & Answers

Can I return to sports after a shoulder dislocation?
A: Yes! Most people can return to sports within 4-6 months, depending on the severity and whether surgery was needed. Physiotherapy is key to preventing future dislocations.

Will my shoulder dislocate again?
If you’ve had one dislocation, you’re at a higher risk of future dislocations, especially if you’re under 25 and play contact sports. Strengthening the shoulder can reduce the risk. Surgery may be needed for chronic instability.

Does a dislocated shoulder always require surgery?
No. First-time dislocations are often managed without surgery using a sling, rest, and physiotherapy. Surgery is considered if recurrent dislocations occur.

How painful is shoulder dislocation surgery?
Pain is managed with nerve blocks and painkillers. Most patients feel significant relief within a few days, and pain reduces as healing progresses.

What happens if I don’t treat a dislocated shoulder properly?
A: Ignoring a shoulder dislocation can lead to chronic instability, recurring dislocations, labral tears, and arthritis. Seeking treatment early prevents long-term damage.