What is shoulder subluxation?
Shoulder subluxation, more informally referred to as shoulder instability, occurs when the upper arm partially dislocates from the shoulder socket. Many people confuse shoulder subluxation with a shoulder dislocation, but there are a few key differences. Think of your shoulder joint like a golf ball sitting on a tee. The golf ball is the humerus and the tee is the socket, or glenoid. When the shoulder dislocates, the humerus or “ball” becomes dislocated from the shoulder socket and requires a professional to reset it. A subluxation, however, is when the humerus is partially dislocated but naturally pops back into place. It can occur during sports that involve throwing like football and baseball, and it’s usually accompanied by a weak, numb feeling as well as a sharp pain in and around the shoulder.
Causes of Shoulder Subluxation
The most common cause of shoulder instability is a traumatic injury to the shoulder. This is one of the reasons why this injury is most common among boxers and football players. For non-athletes, it is usually a hard fall or accident. However, there are also people who have naturally looser ligaments in their shoulders and are more susceptible to injury. No matter the cause, many people suffer from shoulder instability and do not appropriately take care of it.
Similar to a twisted ankle, once a person suffers a dislocated shoulder the chances of it happening again are very likely. The recurrence rate in patients under 20 is 95% and 40-50% in patients 40 and over. The reason for this is that when the injury occurs, the tendons and ligaments in the shoulder socket are torn and then heal back in a stretched position. This gives the shoulder a wider range of motion as well as less stability. If not treated properly, the shoulder can continue to sublux and lead to multi-directional instability (MDI), which can be especially harmful. This is why treatment and rehab are absolutely key in preventing further injuries.
The first action one should take is to ice and rest the shoulder to help with the swelling and pain, as well as taking an over-the-counter anti-inflammatory. Immobilization of the shoulder is important in helping the muscles and tendons heal. A shoulder brace of some kind, like our DonJoy Ultra Sling, will be beneficial in this regard. The brace should typically be worn for about 3-6 weeks to allow the ligaments and tendons to heal properly and to prevent re-aggravating the injury. If the shoulder does not heal and chronic pain persists, surgery may become necessary, but this is not common.
Because of the nature of the injury, it is difficult to say when one should begin rehabilitation for shoulder subluxation. On average we recommend at least 6-8 weeks after the injury before beginning rehab, but prefer up to three months to be on the safer side. After you have allowed the shoulder to rest and the pain has subsided, you will need to start strengthening the muscles in and around the shoulder socket. Begin lightly and slowly increase the weight and intensity until the shoulder begins to feel strong and secure. It may take several months until the shoulder is fully healed, so remember to take care and abstain from activates that could re-aggravate the injury such as contact sports or movements that exert extreme torque on the shoulder like tennis or golf. Proper treatment and rehabilitation will greatly reduce your chances of recurring injuries and complications. However, the shoulder will most likely never be as strong as before so remember to treat it accordingly when performing physical activities going forward.