Shoulder dislocation (instability)
My shoulder popped out. What happens now?
After a dislocation, or when a shoulder feels loose, rehabilitation rebuilds control and strength. Some young athletes need a surgical opinion.
What it feels like
After a dislocation: severe pain, the arm held still and an obviously abnormal shoulder until it is put back. With ongoing instability: the shoulder feels loose, slips or catches with certain positions, often overhead or with the arm out to the side and turned back.
What is actually happening
The shoulder is a very mobile joint held stable by the joint capsule, labrum and rotator cuff muscles. A traumatic dislocation, usually forwards, can stretch or tear these structures. Recurrence is more likely after a first dislocation in young, active people, particularly in contact and overhead sports. Some people have looser shoulders without an injury.
When to see a doctor urgently
A shoulder that has dislocated and not gone back in needs emergency care. Go to an emergency department straight away if you have numbness, weakness or a cold, pale hand after a dislocation. A first dislocation should be assessed by a doctor, who will usually arrange imaging to check for fractures.
How it is assessed
Assessment includes the injury history and number of episodes, range of motion, rotator cuff strength, specific instability tests, shoulder blade control and the demands of your sport or work.
How it is treated
A consensus statement grading the evidence on shoulder injuries in sport supports exercise therapy for shoulder instability, building rotator cuff and shoulder blade strength and control, progressed to sport-specific positions. A Cochrane review found insufficient evidence to favour one position of sling immobilisation over another after a first dislocation. For young athletes with a first traumatic dislocation, or with repeated dislocations, a discussion with an orthopaedic surgeon about stabilisation surgery is often appropriate, and rehabilitation continues after any surgery.
What to do first
After a first dislocation, see a doctor. Afterwards, follow their advice on the sling, keep the elbow and hand moving, and start rehabilitation early.
Where this is assessed
- Athlete's Care Sports Medicine Centres Yonge & Eglinton · Mon/Wed/Fri · 8:00 AM – 2:00 PM Book at Athlete's Care
- Push Pounds Sports Medicine Downtown Toronto · Tue/Thu · 8:30 AM – 6:30 PM Call Push Pounds to book
References
This page is based on the following clinical practice guidelines and research.
- Liaghat B, Pedersen JR, Husted RS, et al. Diagnosis, prevention and treatment of common shoulder injuries in sport: grading the evidence - a statement paper commissioned by the Danish Society of Sports Physical Therapy (DSSF). Br J Sports Med. 2023;57(7):408-416.
- Braun C, McRobert CJ. Conservative management following closed reduction of traumatic anterior dislocation of the shoulder. Cochrane Database Syst Rev. 2019;5(5):CD004962.