Shoulder > Shoulder Subluxation

What is Shoulder Subluxation?

The three bones that make up your shoulder – the collarbone (clavicle), upper arm bone (humerus), and shoulder blade (scapula) – are held in place by muscles, ligaments, and tendons. When these tissues have been damaged through acute injury or repetitive stress, your shoulder can become loose and unstable. Shoulder subluxation is one outgrowth of shoulder instability. When your shoulder subluxates, your upper arm bone comes part of the way out of the shoulder socket (glenoid), but, unlike during a shoulder dislocation, it is able to return to its normal position.

Causes  

If you have dislocated your shoulder, you are at greater risk for shoulder subluxation if the ligaments and tendons that make up the shoulder joint capsule have not fully healed and are unable to keep your shoulder in place. Dislocations are traumatic injuries that can occur when the arm is extended away from the body and is snapped back, such as when a football player makes a tackle or a baseball player slides headfirst into a base incorrectly. Overuse also can be a contributing factor. Any sport that requires throwing or using an overhead motion, such as baseball, tennis, swimming, volleyball, or water polo, can increase the risk of shoulder subluxation. In addition, some people may be more prone to shoulder instability and possible subluxation if they suffer from general laxity, or looseness, of the joints.

Orthopedic Evaluation  

There usually are three parts to an orthopedic evaluation: medical history, a physical examination, and tests that your physician may order.

MEDICAL HISTORY  

Your physician will ask about your activities, which may have caused your shoulder pain. You will be asked when the soreness or pain began, where in your shoulder it occurs, how long it lasts, and what lessens or worsens it. If you have had any prior shoulder injuries, your physician will ask about treatments you have tried in the past. Physicians also typically ask about other conditions, such as arthritis, diabetes, and allergies, and medications currently being taken. You also may be asked about your athletic goals as well as the physical requirements of your job – information that will help your physician decide what treatment might be best for you.

PHYSICAL EXAM

Your physician will palpate, or feel with the fingers, your shoulder for areas of tenderness, and may assist you in moving your shoulder through its whole range of motion to check for any pain or abnormalities. During this examination, you may feel as though your shoulder is going to come out of its socket. This is a sign of instability, but it will not lead to a dislocation except in rare cases. In some cases, your physician may choose to examine your shoulder while you are under anesthesia and your muscles are relaxed.

TESTS [top]

The following tests may be ordered by your physician:

   X-rays, which can aid in diagnosing tumors or fractures that may be contributing to your shoulder pain.

   Blood tests, to check for any infections or systemic disorders.

   Magnetic resonance imaging, in which dye is injected into the joint, can reveal damage to ligaments and tendons.

   Injection of a local anesthetic into your shoulder, to test for impingement, or pinching, of the rotator cuff.

   An arthrogram, in which dye is injected into your shoulder and X-rays are taken, may be used on rare occasions.


Treatments
Physical Therapy
Open or Arthroscopic Stabilization
 

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