Shoulder Dislocation and Subluxation Specialist

Are you an athlete who participates in contact sports? If so, you may be at risk of sustaining a shoulder dislocation. A shoulder dislocation, also called shoulder subluxation can occur from a sports injury, traumatic blow to the shoulder or from continuous overhead movements. Dislocated shoulder specialist, Doctor Riley J. Williams provides diagnosis and both surgical and nonsurgical treatment options for patients in Manhattan and New York City, NY who have dislocated their shoulder. Contact Dr. Williams’ team today!

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What is a dislocated shoulder?

The shoulder consists of the humeral head (upper arm bone) and the glenoid socket portion of the scapula (shoulder blade) creating a ball-and-socket joint. This joint is markedly versatile as it allows shoulder movement in several directions; shoulder stability is highly dependent on the soft tissue restraints (labrum and capsule) that surround the shoulder joint. Because the shoulder socket is shallow, the humeral head can oftentimes dislocate easily. A shoulder dislocation can be classified in one of three ways: 1) a forward (anterior), backward (posterior), and downward (inferior) Causes of shoulder dislocations include: falls on an outstretched arm, traumatic collisions, traction injuries that pull on the arm, and seizures. It is imperative to seek immediate medical attention, either from a medical professional or an orthopedic shoulder specialist, if a shoulder dislocation is suspected. Dr. Riley J. Williams, an orthopedic shoulder specialist serving patients in Manhattan, New York City, and the surrounding New York boroughs, has the knowledge and understanding, as well as substantial experience, in treating patients who have experienced a dislocated shoulder.

What is a dislocation or subluxation of the shoulder?

Depending on the severity of the injury, the shoulder joint can be partially, or completely, separated. A partial dislocation event is known as a subluxation. This generally occurs after a traumatic blow to the shoulder resulting in the humeral head partially slipping out of the socket. It is common for these kinds of partial dislocations to be spontaneously reduced (returned back to the socket).

What causes shoulder instability? Is it related to a dislocated shoulder?

The ligaments located within the shoulder joint extend and periodically tear when this joint becomes separated. Shoulder instability is the result of these ligaments becoming weak or stretched. This weakness and ligament laxity increases the probability of repeated joint slippage and subluxation. If the dense, fibrous cartilage lining the shoulder joint, known as the labrum, is torn from a shoulder dislocation, the stability of the joint is further weakened thereby increasing the probability of recurrent dislocations.

What causes shoulder instability?

Is shoulder instability related to a dislocated shoulder?

The ligaments located within the shoulder joint extend and periodically tear when this joint becomes separated. Shoulder instability is the result of these ligaments becoming weak or stretched. This weakness and ligament laxity increases the probability of repeated joint slippage and subluxation. If the dense, fibrous cartilage lining the shoulder joint, known as the labrum, is torn from a shoulder dislocation, the stability of the joint is further weakened thereby increasing the probability of recurrent dislocations.

Are certain populations more at risk for shoulder dislocations or shoulder instability?

Yes. Shoulder dislocations and subluxations are the highest among young people. Athletes who participate in sports such as football, wrestling, rugby and hockey, where more aggressive contact is prominent, are at higher risk of shoulder dislocations. Athletes who also participate in sports such as volleyball, baseball, and tennis, where repetitive overhead motions are involved, are more likely to weaken the shoulder ligaments and develop shoulder instability.  Shoulder dislocations can occur in any age group; the younger you are at the time of your first dislocation, the higher the likelihood of a recurrent dislocation in the future.

What are the symptoms of a dislocated shoulder?

Shoulder pain resulting after an injury and worsens with movement is the most common complaint of a shoulder dislocation. If shoulder dislocation or subluxation is presumed, immediate medical attention by a medical professional or orthopedic shoulder specialist is advised. Other common symptoms of a dislocated shoulder, or shoulder instability, include:

  • A visibly displaced shoulder
  • Pain
  • Swelling
  • Numbness of the affected arm
  • A “crunching” or “popping” sensation of the shoulder joint
  • Difficulty with arm movement
  • Decreased range of motion

How is shoulder instability diagnosed?

An extensive medical history and physical examination will be obtained by Dr. Williams. Assessment of the injured shoulder’s strength and range of motion will be included as part of the physical examination. Depending on the severity of the injury, diagnostic testing may be necessary. X-rays are obtained to rule out additional bone-related injuries such as a fracture. Magnetic resonance imaging (MRI) can confirm the extent of shoulder instability, and determine if any other structures within the shoulder joint were injured. Dr. Williams may suggest an arthrogram with the MRI. This imaging technique employs injected dye to evaluate the internal structures within the shoulder joint.

What is the treatment for shoulder dislocation and shoulder instability?

After reviewing the diagnostic imaging, Dr. Williams will create an individualized treatment plan based on the patient’s age, activity level, and degree of dislocation or shoulder instability.

Non-surgical treatment:

If the shoulder joint is out of place, a technique known as reduction will be utilized to place the joint back to its normal position. Reduction of the shoulder joint should only be performed by a professional who is experienced in the manual manipulation of the humeral head back into the glenoid. If the shoulder joint is successfully reduced, the shoulder pain should be markedly reduced almost immediately.

Upon a successful reduction of the shoulder joint, Dr. Williams will apply a sling to immobilize this joint to allow the ligaments to heal properly. A combination of rest, ice, and anti-inflammatory medications are also recommended. If pain of the affected joint is still bothersome following a successful reduction, a steroid injection may be administered to decrease the inflammation within the shoulder joint. Most patients will undergo some physical therapy to restore normal shoulder joint motion and function.

Surgical treatment:

If reduction of the shoulder joint is unsuccessful, the patient may need to be sedated to facilitate joint reduction. In rare cases, a fixed dislocation may need immediate operative repair.

Most cases of shoulder instability that do not respond to physical therapy will require surgery. The basic tenet of shoulder instability surgery is the restoration of the ligamentous attachments of the labrum/capsule back to the glenoid socket. Dr. Williams may recommend a shoulder arthroscopy which is a procedure that incorporates a small camera into the shoulder joint to better view the damaged ligaments. This minimally invasive surgical technique is effective at correcting shoulder instability by repairing the damaged ligaments, while allowing patients to return to their normal activities within a shorter period of time.

For more information on complete shoulder dislocations, subluxation, or shoulder instability, or on the excellent treatment options available, please contact the office of Dr. Riley J. Williams, an orthopedic shoulder specialist serving Manhattan, New York City, and the surrounding New York boroughs, NY.

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212.606.1855
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Locations

HSS Sports Medicine Institute West Side
610 W 58th Street
New York, NY 10019

HSS Brooklyn
148 39th Street, 7th Floor
Brooklyn, NY 11232

Office Hours

Monday-Friday: 9:00 am – 4:30 pm
Fax: 212-774-2895