By Frank Alberta

My first shoulder dislocation! Now what?

football-102670_1280After your fingers, your shoulder is the most common joint to dislocate (and you have 10 fingers with 3 joints each).  Shoulder dislocations are very common in young athletes, especially wrestlers and football players.  These injuries result in a huge amount of lost playing time and can lead to bigger problems with the shoulder joint later in life.

Shoulder dislocations can happen at any age but are particularly problematic the younger you are at the time of the first dislocation.  Why?  Because age is the single most important factor in determining if your shoulder is likely to come out again.  Re-dislocation rates in patients under the age of 18 can be as high as 90%!  That means that a high school athlete with a first time shoulder dislocation has only about a 1 in 10 chance of making it through their school sports career without it popping out again.  Even worse…the more the shoulder pops out, the less likely we can treat it successfully, even with surgery in the future.

So what is the best treatment for a first time shoulder dislocation in a young athlete?  Well that depends on what sports they play, what time during the season the injury occurred, what position they play, and whether or not it is in their dominant arm.  Every dislocation that doesn’t pop back in on its own should be reduced by a medical professional and new x-rays should be taken.  The shoulder should be immobilized until you are seen by a sports medicine specialist who can help determine the best treatment in terms of length of immobilization and whether or not surgery is indicated.  A general rule of thumb is the younger the patient, the longer he or she should be immobilized.  Once the shoulder has healed sufficiently, physical therapy exercises can be started.  Figuring our when an athlete can return to play is very individual but is typically not allowed until range of motion and strength are back to normal.

So when is surgery necessary?  If the shoulder stays unstable, or comes out again after it was appropriately treated, surgery should be considered.  MRI scans are usually ordered at this time and almost always show a labrum tear in the front of the shoulder known as a Bankhart lesion.  This can be fixed with an arthroscopic procedure or with classic open surgery.  What is right for you is best determined by your treating physician.  Either way, it will take about 6-9 months to return to the field after your Bankhart repair.

We have 12 years of experience with treating every level of athlete with shoulder instability and are always available to help you make decisions about your shoulder.  Call us to make an appointment.

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