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Recurrent Shoulder Dislocation
Recurrent Shoulder Dislocation
Recurrent shoulder dislocation is a disorder that occurs when the glenohumeral joint, or shoulder joint, is repeatedly dislocating. The shoulder is one of the most mobile joints in the human body, and as such is the most likely to dislocate. Shoulder dislocation can be either anterior or posterior, with anterior being more common. Shoulder dislocation can be caused by a traumatic event such as falling onto an outstretched arm, but can also be caused by repeated stress on the joint due to certain sports or activities. The most common symptom of shoulder dislocation is pain, which may occur suddenly or gradually depending on whether it was traumatic or chronic.
Signs and symptoms:
Significant pain, sometimes felt along the arm past the shoulder.
Sensation that the shoulder is slipping out of the joint during abduction and external rotation.
Shoulder and arm held in external rotation (anterior dislocation), or adduction and internal rotation (posterior dislocation). Resistance of all movement.
Numbness of the arm.
Visibly displaced shoulder. Some dislocations result in the shoulder appearing unusually square.
No palpable bone on the side of the shoulder.
Complications may include a Bankart lesion, Hill-Sachs lesion, rotator cuff tear, or injury to the axillary nerve.
A shoulder dislocation often occurs as a result of a fall onto an outstretched arm or onto the shoulder.
They are classified as anterior, posterior, inferior, and superior with most being anterior.Males are affected more often than females.
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What causes recurrent shoulder dislocation ?
The cause of recurrent shoulder dislocation is not fully understood and there are many factors that could contribute to its development.There are many other causes of recurrent shoulder dislocations, but the most common cause is having surgery on that same shoulder after it has been previously injured.
Recurrent shoulder dislocation may have traumatic or atraumatic cause. There is a high recurrence rate after a primary shoulder dislocation, which is greatest in individuals < 20 years old
There are three main common causes that a shoulder can become unstable:
Earlier History of Shoulder Dislocation :
Severe injury or trauma, is often the cause of an initial shoulder dislocation. When the head of the humerus dislocates, the socket bone (glenoid) and the ligaments in the front of the shoulder are often injured.
The labrum — the cartilage rim around the edge of the glenoid — may also tear. This is commonly called a Bankart lesion.
A severe first dislocation can lead to continued dislocations, giving out, or a feeling of instability.
Repetitive Strain
Some people with recurrent shoulder instability have never had a dislocation. Most of these patients have looser ligaments in their shoulders.
This increased looseness is sometimes just their normal anatomy. Sometimes, it is the result of repetitive overhead motion.
Swimming, tennis, and volleyball are among the sports that requiring repetitive overhead motion and that can stretch out the shoulder ligaments. Many jobs also require repetitive overhead work.
Looser ligaments can make it hard to maintain shoulder stability. Repetitive or stressful activities can challenge a weakened shoulder. This can result in a painful, unstable shoulder.
Multi-directional Instability
In a small minority of patients, the shoulder can become unstable without a history of injury or repetitive strain.
In such patients, the shoulder may feel loose or dislocate in multiple directions, meaning the ball may dislocate out the front, out the back, or out the bottom of the shoulder. This is called multidirectional instability.
These patients have naturally loose ligaments throughout the body and may be “double-jointed.”