Each time you wince when you see your child take a hard hit during a game or practice, a shoulder dislocation is one of the potential fears behind the grimace.
Combining severe pain with potential season-ending implications, a shoulder dislocation is often on the mind of parents of young athletes.
Shoulder injuries are among the most common injuries young athletes face. Dislocations — when the rounded end of the upper arm bone pops out of the cup-shaped socket in the shoulder blade — can be particularly painful and limiting.
Because of the way it is built, the shoulder is uniquely vulnerable to dislocation. And, especially for older teen athletes, a single dislocation is very likely to repeat itself, raising important questions about whether surgery is the right answer.
If your child participates in a contact sport, learning about the possibility of a shoulder dislocation and potential treatment options will help you prepare in case it happens.
Why Shoulders are Vulnerable
Every joint in our body is a compromise between range of motion and stability. For example, the hip carries much of our weight and is stable but not very flexible.
However, no other joint offers the range of motion of the shoulder, and no other joint is dislocated as often. Most troublesome, a single dislocation raises the risk of repeated injury more than any other joint, especially for young players who return to their sport.
Among teen boys who dislocate their shoulder and are not treated with surgery, repeated studies have found the majority go on to experience another dislocation. One study found 86 percent of 15-year-old boys who dislocated their shoulder had another dislocation within two years.
For girls of the same age, that figure was 54 percent.
However, studies have also found that younger children, aged 10 to 13, have a relatively low rate of multiple dislocations. In one study, only one in five children this young who dislocated their shoulder had another dislocation.
A shoulder dislocation can have mental and emotional consequences, too. Players sometimes worry that another dislocation will occur and feel depressed if the injury or surgery keeps them off the field and away from friends.
The shoulder is also a key area in children because most of their arm growth happens here, at the upper end of the upper arm bone, or humerus. Injuries to this part of the bone often require close observation by a doctor to ensure they don’t lead the humerus to grow off-course.
What to Watch For
Most shoulder dislocations occur when the arm bone comes out of its socket and is moved forward, toward the front of the body.
In addition to being caused after a violent impact, shoulder dislocations have some tell-tale signs. They include:
- Intense pain
- The child supporting the injured arm with the other hand to take the weight off
- Weakness, tingling and numbness in the hand, fingers and arm
In the process of the arm bone being pulled from its socket, the muscles and tendons that surround the joint can be injured, as well. Called the rotator cuff, this area is critical to the healing process of a shoulder dislocation.
Sports with Higher Shoulder Dislocation Risk
Dislocated shoulders are most common in contact sports like lacrosse, football, wrestling and rugby.
For example, one study found that one in seven rugby high school rugby players experienced a shoulder dislocation. Another found that seven percent of hockey players were hurt this way.
As it is for many youth injuries, football is the source of most shoulder dislocations.
One analysis of all the shoulder injuries among youth athletes for the seven school years beginning in 2005 tallied up a whopping 463,632 shoulder injuries in football. That’s about 58 percent of the total for all youth sports.
That study found most shoulder injuries in football and wrestling occurred during tackles and takedowns.
There are gender differences in how young athletes dislocate their shoulders, too.
In soccer, girls are more likely to hurt their shoulders by falling and hitting the ground, whereas boys were likelier to hurt their shoulders through contact with other players.
Still, shoulder injuries are relatively rare in soccer, comprising only a few percent of all injuries in the sport, according to one study.
How to Treat Shoulder Dislocation
Though emergency treatment is needed to return a dislocated shoulder back into its socket, it usually does not require surgery. Doctors will also look for evidence of injuries that can accompany dislocations, such as bone fractures and nerve injuries.
Treatment begins by resting the joint, often using a sling followed by physical therapy to strengthen the muscles, ligaments and tendons of the shoulder.
Follow-up treatment varies athlete to athlete. Most young athletes who dislocate their shoulder can return to their sport, though their families should work with doctors to develop a follow-up plan to minimize the risk of another dislocation.
This is one example of the value of Florida Hospital's network of care for children. Whether you’re first treated in an urgent care or an emergency department, your child will benefit from a team of specialists working together to help your family achieve its goals.
This team might include physical therapists to develop shoulder-strengthening exercises and orthopedic surgeons to go in-depth about the risks and benefits of surgery.
In those cases when physical therapy and other lifestyle changes aren’t enough, surgery may be considered to reduce the risk of re-injury. Using small incisions and a tiny camera, an orthopedic surgeon can use a variety of procedures to repair the tendons and ligaments in the rotator cuff.
Florida Hospital’s long history of caring for children has taught us that restoring physical health is just one part of living well. In fact, people and families thrive best when complete health — in body, mind and spirit — is in balance. And when it comes to orthopedic health, your child will be cared for with this balance in mind.
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