Dislocated your Shoulder? What Treatment Path Will You Take?
Have you dislocated your shoulder for the first time and are you wondering whether you should have some surgical intervention or treat it conservatively and hope it does not happen again?
Shoulder dislocation can be caused by 3 things:
- Traumatic Instability – which could happen during sporting activity where there is a force big enough to pull the shoulder out of the joint.
- Non traumatic dislocation – due to structural damage
- Muscle patterning – this usually occurs in younger people who can slip their shoulder out of their joint as a party trick. The shoulder may then progress to dislocate involuntarily due to abnormal muscle patterning.
However, a lot of the time shoulder dislocation is normally a combination of all 3 factors.
After A&E have relocated your shoulder joint, your orthopaedic consultant might mention diagnosis of Bankart Lesion, Hills-Sachs lesion (normally caused by recurrent dislocation), rotator cuff tears, SLAP lesions and glenoid bone loss. This is because a shoulder dislocation does not happen in isolation to damage to the surrounding structures.
From research, 60% of people that have dislocated their shoulder will dislocate it again with conservative treatment, but this risk is reduced, as you get older and increases to 80% if you are a sportsman. Whereas surgical intervention reduces the likelihood of dislocating your shoulder again to 2.7% over the review period of 10 years, there are risks to surgery such as neurovascular damage (>1%), stiffness due to soft tissue structures (2-15%), chondrolysis and infection (0.04-0.23%).
The other factor to consider when considering a path of treatment is the increased risk of osteoarthritis (OA) in the shoulder. Statistics state that after your first dislocation you are increasing your risk of OA to 17% and recurrent dislocations increase it to 43%.
Whatever route you decide to take most surgeons like Mr Ali Narvani recommends physiotherapy to either assist regain of movement and strength around your shoulder after surgery, or regain muscle balance to help with conservative management.
So what would you do? Have you dislocated your shoulder before? Let us know what treatment path you took in the comments section below.