What is shoulder subluxation?
Shoulder subluxation is a partial dislocation of your shoulder. Your shoulder joint is made up of the ball of your arm bone (humerus), which fits into a cup-like socket (glenoid).
When you dislocate your shoulder, the head of your upper arm bone pulls completely out of its socket. But in a shoulder subluxation, the head of the arm bone only comes partway out of the socket.
The shoulder is one of the easiest joints to dislocate because it’s very mobile. That mobility allows you to swing your arm all the way around, like to throw a softball pitch. Throwing too rapidly or forcefully can cause the joint to sublux, but often this injury happens after years of repeated use.
In a subluxation, the bone can shift forward, backward, or downward. Sometimes the injury also tears muscles, ligaments, or tendons around the shoulder joint.
What does it feel like?
A dislocated or subluxed shoulder can cause:
- numbness, or a pins-and-needles feeling in your arm
With a subluxation, the bone may pop back into the socket by itself.
Both subluxation and dislocation can cause similar symptoms, so it can be hard to tell the difference without seeing a doctor.
When to seek medical attention
Get medical help if your shoulder doesn’t pop back into the joint by itself, or if you think it might be dislocated. Don’t try to put it back in place yourself. You might damage the ligaments, muscles, and other structures around the shoulder joint.
If you can, put on a splint or sling to hold the shoulder in place until you can see your doctor.
How will your doctor diagnose it?
Your doctor will ask about your symptoms and perform a physical before examining your shoulder. You may need X-rays to see if the head of the bone has partially or totally come out of the shoulder socket. X-rays can also show broken bones or other injuries around your shoulder.
Once your doctor determines the extent of your injury, they can help put your shoulder back into place and develop a care plan.
What does treatment consist of?
Putting your shoulder back into place is key. Although this can be done right on the field or wherever the injury happened, it’s safer to have a doctor perform this technique in a medical office or emergency room.
Doctors move the shoulder back into place using a procedure called closed reduction. Because this process can be painful, you may get a pain reliever beforehand. Or, you might be asleep and pain-free under general anesthetic.
Your doctor will gently move and rotate your arm until the bone slides back into its socket. The pain should ease once the ball is back in place. Your doctor may do X-rays afterward to make sure your shoulder is in the correct position and that there are no other injuries around the shoulder joint.
After a closed reduction, you’ll wear a sling for a few weeks to keep the shoulder joint still. Immobilizing the joint prevents the bone from slipping out again. Keep your shoulder in the sling, and avoid stretching or moving it too much while the injury heals.
The pain from a subluxation should ease up once your doctor performs a closed reduction. If you still hurt afterward, your doctor can prescribe a pain reliever, such as hydrocodone and acetaminophen (Norco).
However, you shouldn’t take prescription pain relievers for more than a few days. They’re known to become habit-forming.
If you need longer pain relief, try an NSAID such as ibuprofen (Motrin) or naproxen (Naprosyn). These medicines can bring down pain and swelling in the shoulder. Follow the directions on the package, and don’t take more of the medicine than recommended.
If your pain continues after a few weeks, ask your doctor for other pain relief options.
You might need surgery if you have repeated episodes of subluxation. Your surgeon can fix any problems that are making your shoulder joint unstable.
- ligament tears
- tears of the socket
- fractures of the socket or head of the arm bone
- rotator cuff tears
Shoulder surgery may be done through very small incisions. This is called arthroscopy. Sometimes, it will require an open procedure/reconstruction called an arthrotomy. You will need rehabilitation after surgery to regain movement in the shoulder.
Rehab can help you regain strength and movement in your shoulder after you have surgery or when your sling is removed. Your physical therapist will teach you gentle exercises to strengthen the muscles that stabilize your shoulder joint.
Your physical therapist might use some of these techniques:
- therapeutic massage
- joint mobilization, or moving the joint through a series of positions to improve flexibility
- strengthening exercises
- stability exercises
You will also get a program of exercises to do at home. Do these exercises as often as your physical therapist recommends. While you’re recovering, avoid sports or other activities that might reinjure your shoulder.
Tips for home care
To take care of your shoulder at home and avoid reinjury:
Apply ice. Hold a cold pack or bag of ice to your shoulder for 15 to 20 minutes at a time, a few times a day. The ice will relieve pain and bring down swelling right after your injury. After a few days, you can switch to heat.
Rest. Once you’ve subluxed your shoulder the first time, it’s more likely to happen again. Avoid any activities that could pull the ball of your arm bone out of its socket, like throwing or lifting heavy objects. Ease back into sports and other activities slowly, only using your shoulder as you feel ready.
Work on flexibility. Do the exercises your physical therapist recommended every day. Doing regular gentle movements will prevent your shoulder joint from getting stiff.
Are complications possible?
Complications of a shoulder subluxation include:
- Shoulder instability. Once you’ve had a subluxation, it’s more likely to happen again. Some people get subluxations over and over again.
- Loss of movement. Damage to your shoulder can cause a loss of flexibility.
- Other shoulder injuries. During a subluxation, ligaments, muscles, and tendons in your shoulder can also get injured.
- Nerve or blood vessel damage. Nerves or blood vessels around your shoulder joint can be injured.
What’s the outlook?
You’ll wear a sling to hold your shoulder in place for one to two weeks. After that, you should avoid intense movements of the shoulder for about four weeks.
Once you’ve subluxed your shoulder, it’s more likely to happen again. If you get shoulder subluxations often, you might need surgery to stabilize your shoulder.
After surgery, it takes about four to six weeks for your shoulder to recover. Your arm will be in a sling most or all of this time. Athletes might not be able to fully participate in sports for a few months after their surgery.