Dislocation of the shoulder joint. Treatment, rehabilitation, exercise, symptoms in adults, child, first aid, x-ray

At dislocation of the shoulder joint we are talking about a pathological situation when contact between the joints of the shoulder and scapula is lost. Usually, in such situations, you cannot do without treatment, rehabilitation exercises and other procedures aimed at alleviating the condition.

Sometimes, against the background of displacement of bones, there is a risk of rupture of the articular bag of ligaments. However, in the medical field, dislocation of the joint in the area between the scapula and the clavicle is not considered a pathology of the traumatological type.

Dislocation of the shoulder, according to statistics, is one of the most common types of injuries, from which up to 60% of people who go to a trauma center suffer. Such high statistics are explained by the fact that this area of ​​the human body has functional as well as structural features.

The shoulder joint is highly mobile and is most often involved in movement. This part of the human body is capable of moving with a large amplitude, which leads to quite frequent dislocations.

Types of stage and degree

There are several classifications of this type of dislocation. For example, it can be of a congenital type or resulting from an injury. In the first case, we are talking about an anomaly that is diagnosed in a patient from birth. The resulting dislocation can be traumatic or non-traumatic.

In the first case, there is also a complication (if the patient additionally registers injuries in the form of fractures and other injuries). Also, damage is classified according to the movement of the bone. Based on this parameter, there are 3 types of dislocation of the shoulder joint.

Dislocation type	Peculiarities
Front	When retracted, the upper limb takes up a free position. The shape of the shoulder becomes more angular than that of a healthy limb. If you try to feel the area under the collarbone, you will feel the head of the humerus. In this case, the patient on his own cannot abduct the shoulder, rotate it. The injured hand cannot touch the other shoulder. Such manipulations are very painful.
Rear	The injured limb is in a position that is characteristic of internal rotation. When looking at the shoulder, it becomes obvious that it has acquired a sharp, angular outline. In this case, the coracoid process of the scapula, which protrudes, is visible to the naked eye. The patient is unable to abduct and rotate the shoulder on his own. When trying to perform the movement, acute pain appears.
Lower	The pain disappears when the arm is bent at the elbow and slightly abducted. In this case, the forearm is above the level of the head. When feeling the armpit, you can feel the head of the humerus.

As a rule, doctors most often register the received anterior type of injury. Also, damage of this type is fresh, stale or old. It all depends on when exactly the patient asked for help.

Sometimes people notice only minor pain and discomfort, which is why they do not take any measures for treatment. As a result, damage of the old type is formed.

Dislocation of the shoulder joint (treatment, rehabilitation, exercise and medical supervision are important for correct restoration of motor function) differs not only in the mechanism of damage, but also in the manifestation of damage limbs.

Symptoms

It is far from always possible to provide timely assistance to the victim, since the patient may assume that the discomfort will go away on its own. Some believe that they have suffered from minor stretching and prefer to simply reduce their physical activity for a while.

But, there are a number of manifestations that you should pay attention to:

• Severe cutting pain. The symptom appears immediately after the dislocation. The most severe pain occurs in people who have a dislocation for the first time. If this type of damage occurs not for the first time, then the pain syndrome may not be so acute or not at all. The appearance of symptoms is due to rupture of the articular tissues. It contains many nerve endings, which lead to severe pain. Also, the intensity of the symptoms can be a sign of rupture or other damage to the ligaments or tendons.
• Restricted mobility. A person is not able to perform purposeful movements. If the turn of the hand is performed with the help of another person, then the so-called spring resistance syndrome is observed. This means that when the limb moves, a kind of elastic resistance is felt. A similar effect is due to the fact that the articular elements have lost contact with each other. This leads to the fact that they are not able to fully perform their function. Also, this type of resistance is a response to pain.
• Deformation. This symptom is of an external type. If a person has suffered from a dislocated joint, then the shoulders will look asymmetrical. A protrusion is visible from the damaged side. Also, the change in the position of the joints is easily detected by touch.
• Puffiness. A similar symptom is a response to the inflammatory process occurring in the injured limb. It occurs by the expansion of small blood vessels. Sometimes puffiness appears against the background of the process of squeezing larger vessels (for example, the axillary vein). In this case, the outflow of the liquid is hindered, which leads to an increase in pressure. With the appearance of edema, an increase in the affected shoulder itself is also observed. In some cases, the swelling can spread to the entire limb. Also, swelling can be accompanied by redness of the shoulder. The skin becomes hot and tight. Any touch brings great pain. This indicates a complication.

The patient can note only one of the described signs or all at once. Nevertheless, even if one of the symptoms appears, it is worth consulting a doctor to eliminate the risk of complications.

Signs of complications

Dislocation of the shoulder joint (treatment, rehabilitation, exercises to restore limb mobility are only part of the complex therapy) can be diagnosed simultaneously with a number of additional damages:

• Bankart. Damage of this type is characteristic of joint ruptures. In addition, there is a separation of the area of ​​the articular lip. With injuries of this type, surgery is very often required. The main danger of this complication lies in the fact that outwardly the defeat of the Bankart may not manifest itself in any way. The patient believes that this is a common dislocation. However, with such an injury, a more severe pain syndrome is observed.
• Hill -Sachs. A complication of this type is a fracture of the posterior region of the humeral head simultaneously with anterior displacement. The main sign of such a lesion is the appearance of bone crunching. But the absence of this symptom does not mean that the patient does not have a Hill-Sachs injury. Therefore, it is important to carry out diagnostic measures.
• Fracture of the shoulder bones. In this case, the presence of injury is noted. The patient may suffer from a fracture. With this type of damage, there are standard lesions characteristic of a fracture (severe pain, inability to move a limb, crunch).
• Nerve damage. This damage affects the nerve bundles. Axillary nerve damage is most often recorded. The patient notes signs of limb numbness, muscle weakening. If the radial nerve is damaged, then the hand or elbow will become immobile.
• Damage to blood vessels. This is an axillary artery injury. Such damage is very rare. Mostly the vessels are affected in elderly patients against the background of atherosclerotic changes. Additional symptoms include the disappearance of pulsation in the area where the radial artery passes.

Reasons for the appearance

There are several factors that can cause dislocation.

They differ depending on the type of damage:

• Anterior dislocation. As a rule, damage of this type occurs against the background of direct impact on the limb. For example, such a diagnosis is often confronted by professional wrestlers and athletes, who often work with crosspieces and rings. Also, an anterior dislocation can result from a strong blow to this area.
• Posterior dislocation. It is less common in medical practice. The cause of the injury is a fairly strong blow directed directly to the distal part of the limb. Also, similar injuries are often found in novice weightlifters who do not properly distribute weight.
• Inferior dislocation. It is diagnosed least often. May occur when performing an exercise called "Flag". Also, this type of injury is diagnosed in athletes who practice hand-walking.

Also in medical practice there is such a thing as habitual dislocation. These are injuries that combine several types of dislocations at once. This condition is of greatest concern to doctors, but it is not so common.

Dislocation of the shoulder joint (without treatment, rehabilitation and restorative exercises, the patient may have problems in future) may also arise due to the increased level of mobility and the small surface area of ​​the contacting joints.

Such injuries also affect people who have an enlarged joint capsule and those who often suffer from limb injuries. In many situations, shoulder dislocation is a consequence of intense mechanical stress on the limb. People face such problems when falling, during which a person puts his hands forward.

Due to the free movement of the shoulder joint, the humerus can move in several ways. But even so, in 98% of cases we are talking about anterior displacement.

Those who have suffered from similar injuries in the past are most likely to get this kind of injury. In medical practice, this phenomenon is called repeated or habitual dislocation.

The problem is that after the initial injury, a rupture occurs in the joint. There is a possibility that the dislocation was corrected and cured incorrectly, due to which the connection between the joint capsule and the ligamentous apparatus was disrupted.

Very rarely, doctors are faced with dislocations, which are the result of sudden muscle contractions. In this case, the person may even have seizures and subsequent problems with the central nervous system.

That is, due to injuries of this nature, there is a risk of developing epilepsy. But, in most situations, this type of defeat does not pose a serious danger. If a person has suffered only from a dislocation, then with proper treatment, the motor activity of the upper limbs will fully recover.

Diagnostics

Without the help of outsiders, it will not be possible to correct the dislocation of the shoulder on your own. Therefore, it is worth contacting a traumatologist and go through the necessary diagnostic measures. The doctor needs to tell the circumstances of the injury and describe the symptoms in detail. After that, the traumatologist must conduct an examination to clarify whether the patient has suffered from a fracture and other additional complications.

To do this, you first need to palpate the damaged area. The doctor also examines the shoulder for deformities.

The most effective diagnostic method is considered to be MRI. If it is not possible to immediately perform a tomography, then an X-ray examination is performed. If you go to the emergency room for registration, then all these activities are performed on the basis of a health insurance policy.

If you go to a private center, then the shoulder MRI procedure will cost about 1,500-2,000 rubles. X-ray will cost about 2 times cheaper. However, it all depends on the specific region and medical institution.

When to see a doctor

A traumatologist should be consulted if, after injury, acute, severe pain in the shoulder is observed. Also, a reason for visiting a doctor is a violation of the mobility of the joint. For example, you can try to touch your affected limb with your fingers to the opposite shoulder. If, when raising an arm, acute pain appears and movement is impossible, then you need to immediately undergo diagnostic tests.

Dislocation of the shoulder joint (treatment, rehabilitation, exercises to restore mobility may be required even with a frivolous damage at first glance) is a particularly dangerous condition if, along with pain syndrome, there is swelling and deformation limbs.

Prevention

To prevent such damage, it is worth following a few guidelines:

• Distribute physical activity during training. Also, during any sports activity, you always need to pre-warm up the muscles.
• Do not engage in heavy physical work (you cannot carry heavy boxes and other objects in your hands).
• Timely treat any diseases of the musculoskeletal system.
• Do not sleep in an uncomfortable position when the shoulder joint is constantly in tension.

It is also worth eating more natural foods that are high in potassium, calcium and other substances necessary for stronger bones.

Treatment methods

Dislocation of the shoulder joint (treatment, rehabilitation, exercise and other activities must be performed strictly according to the doctor's instructions) responds well to treatment if there is no rupture.

In this case, the doctor first sets the humerus, after which immobilization is required, that is, the shoulder must be immobilized so that the damage does not recur until complete recovery. The duration of immobilization is approximately 2-4 weeks. After a month, the doctor draws up a schedule of recovery activities.

If an operation is required, then the recovery period can be up to 12 months.

First aid

If it is not possible to call an ambulance, then the person affected by the dislocation of the shoulder must be taken to the emergency room. Before doing this, it is important to immobilize the shoulder joint, as there is a possibility of a fracture. To do this, you must use any items with which you need to create a stabilizing bandage.

After that, you can give the victim an analgesic. To relieve pain and stop the inflammation process, it is recommended to apply a cold compress to the injured limb. You can hold it for no more than 15 minutes.

Otherwise, there is a risk of frostbite of the skin. Also, avoid applying ice directly to your skin. It is recommended to pre-wrap it in a cotton towel or use a bottle filled with cold water as a compress.

Mode

If the dislocation was complicated by a fracture or an operation was performed, then the recovery process can take from several months to a year. During this time, the patient needs to adhere to the regimen prescribed by the doctor.

Regardless of the complexity of the injury, the limb should not be loaded for the first weeks. As a rule, the person should wear a fixation bandage during this time. Depending on the severity of the injury, the shoulder joint can be gradually developed. To do this, you need to perform the simplest exercises, gradually increasing the load.

Medications

With dislocation of the shoulder joint, drug therapy is primarily aimed at relieving pain.

Therefore, the doctor may prescribe:

• Ibuprofen. It is a non-steroidal pain reliever. It is recommended to take Ibuprofen for injuries of the shoulder joint in the form of tablets (injections are prescribed only for especially severe forms of damage). The dosage is determined by your doctor. As such, there is no course of treatment. In the absence of pain, Ibuprofen should not be taken. The cost of the drug is from 19 rubles.
• Diclofenac. Another pain reliever type. An adult is recommended to take about 100-150 mg per day, but the exact dose is determined by the doctor. It is recommended to divide the medication intake into several parts (for example, in the morning and in the evening). The drug costs about 20-25 rubles.
• Lorazepam. This drug relieves pain and also has a relaxing effect. The daily dose for adults and adolescents is 0.5-4.0 mg in 3 divided doses. The more accurate dosage depends on the individual patient's performance. The cost of the funds is about 120 rubles.

Also, the doctor may prescribe drugs, the action of which is aimed at strengthening the ligamentous apparatus. Such funds include Chondroxide, Teraflex and other analogues. Additionally, it is recommended to use vitamin complexes with a high calcium content.

Traditional methods

In this case, we are talking exclusively about auxiliary therapy, since it is impossible to adjust the shoulder with the help of compresses. But, with the help of traditional medicine, you can relieve pain and relieve swelling.

For example, you can use an alcohol compress. To do this, you need to moisten the bandage in vodka or rubbing alcohol, squeeze out a little and apply to the affected joint for half an hour.

To speed up the healing process for the compress, it is recommended to use warm milk. It also needs to be moistened with several layers of gauze and applied for 30 minutes.

Exercises

The set of exercises and its duration are prescribed only by a doctor, since it all depends on the duration of rehabilitation. Sometimes exercises can be started during the immobilization stage. The first stage includes minimum loads.

For example, on the first day of restorative gymnastics, it is recommended to start with the extension and flexion of the fingers of the injured hand. After that, you can try to bend the limb at the elbow. If there is no strong pain sensation, it is allowed to repeat this procedure.

Gradually the loads increase. Exercises should be aimed at restoring the range of motion. To do this, you need to slowly move your hand to the side, raise and lower it to the possible limit. When pain occurs, the exercise is stopped.

When the fixing bandages are removed, it is allowed to perform more complex exercises using a weight. The schedule for the week and month is made by the doctor, since each patient is provided with a separate therapy.

Other methods

To speed up the recovery process, you can additionally attend hardware physiotherapy procedures.

UHF, magnetotherapy, ultrasound and laser therapy are also effective. The duration of the sessions and the duration of the course are also set by the doctor.

Possible complications

If the damaged joint is not diagnosed and treated, there is a risk that blood circulation will be impaired. This can cause hand numbness. With prolonged disturbance of blood flow, there is a risk of stroke and other dangerous conditions.

In addition, damage of this type can provoke a violation of the transmission of nerve impulses. This means that the mobility of the hand will be impaired.

In case of a dislocated shoulder joint, you should consult a doctor as soon as possible and begin treatment. If you perform the prescribed exercises and other rehabilitation measures, then the mobility of the limb will be restored. It is not worthwhile to engage in therapeutic activities on your own.

Shoulder dislocation video

Malysheva about the dislocated shoulder: