Everyone knows the Lethal Weapon movies and Detective Riggs party trick – getting out of a straight jacket by dislocating his shoulder. He then bashes into a wall to relocate it. Then he gets the bad guys. Ah Hollywood.
When your shoulder dislocates several things happen.
- Tissue damage – ligaments, joint capsule, joint lining, arm bone, shoulder socket, rotator cuff, bicep tendon and sometimes all of the above. There are some people who have really stretchy tissue who don’t do much damage, but they are in the minority. They still get the next 2.
- It hurts – dislocated joints are not normal, and can sometimes be associated with injury to blood vessels and nerves, so your brain justifiably thinks they are pretty threatening. So it’s going to hurt. As we know pain stops things working properly, particularly muscle, and when the cuff muscles are the big stabilisers, that does not suggest easy recovery. If it doesn’t hurt because you have done it so many times that is worse. Much worse.
- Your brain forgets how to use it – a mixture of pain, protective reaction and nervous system changes means that the shoulder goes completely haywire. And it doesn’t remember all by itself.
So even a mild dislocation/subluxation/strain whatever word you use needs to be assessed and managed properly. Otherwise one thing will happen.
- You WILL do it again
The statistics on redislocation are pretty woeful. Partly this is because people try and manage it themselves. But also, it’s a crap injury and it is hard to really make the shoulder function as good as before you injured it, particularly with some tissue damage.
Sometimes rehab is not enough. If you are under 20, suffer a first time dislocation and return to the same sport after awesome, Newcastle Performance Physio-style rehab, you have up to 100% chance you will do it again. If you are under 30, its better, just. Up to 80% chance. Those shoulders need surgery.
Leaving an unstable shoulder will have consequences. I have seen plenty of people who, after waking up at night with a dislocated shoulder, or dislocating their shoulder drying their hair, or a high-five induced shoulder subluxation decide that maybe that’s not normal. It’s never too late to improve it.
It is however, a million-trillion times better to manage the first one as best as possible.
Cross your fingers you don’t dislocate your shoulder. If you do, give us a call. ASAP.
Share with your shoulder-popping friends.
Thanks for reading the Injury misconception trilogy – I’ll see if Disney want to buy the rights.