Recurrent Glenohumeral Dislocation


Q: First off I just want to say that this site is great. I have been suffering from frequent dislocations and no one has been able to to tell me why or how. I started reading the different types shoulder dislocations and the Glenohumeral Dislocation described my situation to a "T". My question to you is until I am able to present this info to my doctor, how can I stabilize the arm to continue with my day to day functions without the risk of dislocating?


A:   Thanks for your kind words of appreciation, they encourage us to keep up the hard work.
Generally, if your shoulder is wrenched upward and backward, you may dislocate it out of its socket .Basically now, try to avoid shoulder straining movements and activities that could potentially produce a new dislocation. The shoulder dislocation is both painful and incapacitating. The force required is often that of a fall or a collision with another person or object (both of which can occur during many sports).
Most shoulder dislocations happen at the lower front of the shoulder, because of the particular anatomy of the shoulder joint. The bones of the shoulder are the socket of the shoulder blade and the ball at the upper end of the arm bone (humerus). The socket on the shoulder blade is fairly shallow, but a lip or rim of cartilage makes it deeper. The joint is supported on all sides by ligaments called the joint capsule, and the whole thing is covered by the rotator cuff.
The rotator cuff is made up of four tendons attached to muscles that start on the scapula and end on the upper humerus. They reinforce the shoulder joint from above, in front, and in back, which makes the weakest point in the rotator cuff in the lower front.
ou can wear a sling, If a sling is not available, rig one by tying a long piece of cloth in a circle (a bed sheet or towel may do nicely). A pillow placed between the arm and body may also help support the injured shoulder.
After a period of immobilization (usually a few weeks), slowly and gradually begin to increase the range of motion at the shoulder joint. This helps to preserve natural movement and lessen the risk of recurrent dislocation which is your particular case here. When good progress is made with range of motion, strengthening exercises may be added to help you to  return to full function.
According to the current medical literature, the recurrence rate for shoulder instability is highly dependent on the age of the patient. Nonoperative care should be performed first before entertaining the thought of surgery. Most patients are able to rehabilitate their shoulder with rest and physical therapy. In patients , as your case, who have recurrent shoulder instability, operative care should be highly considered. Numerous studies have shown the increased likelihood of traumatic glenohumeral  arthritis in patients with multiple shoulder dislocations. Operative care may consist of both open or arthroscopic treatment of the cause of instability, and of course a Rehabilitation program after surgery to control pain, limitation and regain full function.

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