Shoulder Dislocation: Episode 63

  • In this episode: Shoulder dislocation is painful so please do not use force to try to relocate.

  • Chip Review: Tsakiris Chips – Salt (Thank you Dave Bata) (12:53)

  • Trivia question of the week: What is the only number, when spelt out that has the same number of letters as its value? (11:27)

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Brief except from the episode:

Shoulder dislocation, it hurts. The most common cause is trauma, from a fall. The result is where the humerus (the upper arm bone), is no longer contacting the glenoid. Based on the joint configuration it is fairly easy to see why this happens. It is actually surprising this does not happen more often.
The shoulder joint is set up like a golf ball resting on a saucer that is tipped on it’s side. The saucer however, is the size of a golf tee. This is why there is a lot of mobility in the shoulder. It is also the reason why there can be a lot of instability.
Physical therapy can be a good way to help strengthen and stabilize the shoulder joint. Most people who come to physical therapy for a shoulder dislocation do so as a result of recurrent dislocation and are hoping to avoid surgery. Surgery is typically done to repair the labrum or to tighten up the joint capsule.
A lot of people recall the movie Lethal Weapon with Mel Gibson. We see him jam his shoulder into the wall to relocate it. This is 1 million percent the wrong way to try to relocate a shoulder. When a shoulder is dislocated the muscle around the shoulder go into spasm. The spasms prevent relocation. The goal is to try to get the individual with the dislocation to relax. If you can get the upper trapezius, the deltoid and the latissimus dorsi to stop spasming the shoulder will at times relocate on its own. DO NOT FORCE the shoulder to relocate.
Relocating a shoulder is difficult; take the individual to the hospital as soon as possible. Often time’s sedation is the only way to get an individual to relax and get the shoulder to relocate.


Other episodes you might enjoy:

Biceps Tendonitis: Episode 24

Imaging: Episode 45

Adhesive Capsulitis/Frozen Shoulder Syndrome: Episode 26



Shoulder Labrum: Episode 47

Lets start with what the labrum is and does. It is a cartilaginous soft tissue that helps to deepen the relationship between the humorous and the glenoid. The bones that make up the shoulder joint. The bones have a relationship similar to a golf ball and tee, except they are at an 80-degree angle to each other. To keep the bones from falling away from each other the labrum, ligaments and muscles work together to hold them in place. When we see shoulder labrum issues we are usually talking about a SLAP tear. This is an acronym that stands for Superior Labrum Anterior Posterior. This potion of the labrum is where the long head of the biceps brachii attaches. The biceps will tug on the labrum and in bad cases pull the labrum off the bony glenoid. This can result in pain, clicking, loss of ROM and changes to function. Or there can be very little issue. The most common causes of labrum injury are traumatic, usually dislocation or participation in throwing and other overhead sports. Imaging, typically with contrast can be helpful in seeing a tear however, physical examination is very good at determining if a probably tear exists. The most common special tests: Apprehension with Relocation, Load and shift, Sulcus sign, Crank test, and O’brien test. Symptom pattern is often pain referral by the axillary nerve into the deltoid and teres minor as well as pain in the long head of the biceps tendon. With audible clicking and feeling of instability.
Other episodes you might be interested in:

Shoulder Pain: Episode 4

Upper and Lower Extremity Posture: Episode 8

Rotator Cuff Injury: Episode 18

Imaging: Episode 45

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