The shoulder joint is considered the most mobile joint. It provides all the basic functions of the limb. At the same time, the arm can bend and move normally in absolutely any planes. Sometimes a subluxation of the shoulder occurs due to decreased stability.
They lead to limited mobility and provoke quite a lot of pain. Basically, their subacute course is observed. It is important to pay attention to the appearance of symptoms and treat them to prevent the development of complications.
Classification
If there is a partial slippage of the head from the articular cavity, then this is a subluxation of the shoulder. This condition indicates instability of the shoulder joint. There are such types of subluxations as:
- front;
- rear;
- bottom.
In an anterior lesion, the head of the bone moves slightly forward, falling under the shoulder blade. Posterior subluxation occurs when you fall on an outstretched arm. It is caused by tearing of cartilage. With inferior subluxation, the articular head moves beyond the border of the cavity.
According to the time of occurrence, subluxation can be congenital and acquired. The first is diagnosed in a child, so it can be detected in a newborn or in the first year of his life. Acquired subluxation is typical for school-age children and adults. It is also sometimes seen in the elderly. This form is divided into habitual and traumatic.
Habitual subluxation of the shoulder is characterized by a disruption in the damaged area, even with minor loads. This happens in the case of an unbaked injury, irritation of nerve endings, blood vessels, as well as in case of other violations of the articular integrity.
Traumatic shoulder subluxation is much more common. It can come with complications. These include rupture of soft tissues, nerves, vessels and tendons.
If the instability develops only in one direction, then it is called uniplanar. It is often provoked by ruptures of the articular capsule or significant damage to the cartilaginous lip. Multiplanar develops with stretching of the ligaments and tendons and the synovial membrane. In this case, excessive mobility along several axes at once is characteristic. The type of instability that occurs in the shoulder joint will largely depend on the symptoms of shoulder subluxation.
Reasons
Shoulder subluxation has a variety of causes, but it is often caused by trauma or mechanical stress. Provoking factors include:
- congenital anomalies;
- injuries;
- increased activity;
- stretching of the joint capsule;
- arthrosis, arthritis;
- systemic and other pathologies.
Injury is a fall on an outstretched arm or shoulder and entails a fracture of the glenoid cavity, processes of the scapula and head of the bone. Congenital anomalies - an anatomical feature of the development of the articular depression in the scapula.
Increased joint activity is a pathology in which uncharacteristic movements appear. Excessive mobility of the shoulder joint occurs in approximately 10-15% of the inhabitants of the planet.
Stretching the joint capsule is provoked by the implementation of repetitive movements. They cause permanent sprains, capsules. Athletes, namely tennis players and swimmers, often suffer from such a violation.
Repeated injuries to the shoulder cause the ligaments to weaken and as a result, the stability of the joint weakens. Shoulder subluxation is caused by the fact that the muscles of the shoulder joint cannot fully recover after the patient has dislocated the shoulder due to an injury.
Repeated subluxation of the shoulder can trigger daily movement. Moreover, over time, the stability of the joint is increasingly disturbed. As a result, the intervals between relapses are reduced.
Symptoms
The symptoms of shoulder subluxation are quite characteristic, so it is quite easy to recognize the course of the violation. To make a correct diagnosis, the doctor conducts a survey for the presence of certain complaints. Subluxation is accompanied by certain symptoms, which are determined not only by thetrauma, but also its mechanism. With a sharp impact of external factors, rather intense pain in the shoulder occurs, associated with rupture of ligaments, tissues and joints. However, with chronic instability, such sensations become much weaker or disappear altogether. In addition to painful manifestations, habitual shoulder subluxation is characterized by such signs as:
- joint deformity;
- restriction of movements;
- forced limb position;
- tingling, numbness.
With multiplanar instability, patients experience excessive displacement of the head of the shoulder during movement, muscle tension and increased fatigue. Some people have signs of connective tissue dysplasia, which should be attributed to such as:
- maybe touch your forearm with your thumb;
- excessive extension at the elbows;
- can be reached with the index finger of the back of the hand.
These signs do not indicate the presence of a dislocation, but indicate a high risk of its development. A chronic course of the pathology is possible in the event that a person has previously had a dislocated shoulder and this led to negative consequences. The stretched musculoskeletal apparatus cannot fully perform its functions, so the joints become vulnerable and can be subject to various injuries. A similar problem is quite often observed with subluxation of the shoulder in infants, as well as in athletes.
Diagnostics
To confirm subluxation of the shoulder in a child or adult, you needsee a doctor for a diagnosis. To do this, the doctor initially examines the patient, as well as clinical trials. A person experiences severe pain, so he tries to limit movement. In case of injuries, instrumental techniques may be required to see the damaged skeletal structures and assess the degree of pathology. This allows you to do such procedures as:
- magnetic resonance imaging;
- radiography;
- CT scan.
The bones are clearly visible on the x-ray, but this method does not allow assessing the condition of the soft tissues. MRI allows a good view of the structure of the synovial membrane, tendons and muscles, ligaments, cartilage tissue. This greatly facilitates the diagnosis.
Fracture of the shoulder with subluxation is quite common, which is why it is absolutely necessary to make a diagnosis. The nature of the damage will largely depend on the mechanism of injury, which determines the essence of therapeutic procedures.
Feature of treatment
If the movement is accompanied by pain, then you need to fix the hand in a certain position to keep it stationary. Ice should be applied to the injured area.
The duration of the recovery period after an injury is usually 1-1.5 months. During the treatment of subluxation of the shoulder, you need to take painkillers. For a quick recovery, it is important to strictly follow all the recommendations of the doctor. It is necessary to avoid unnecessary movements without loading the hand.
Usefulengage in physical therapy, which will help strengthen the muscles. This will help protect against subluxations in different parts of the body. In order for the joint to recover very quickly, regular massage is needed.
When playing sports and other loads, it is important to adequately assess your capabilities and pay special attention to the muscles. It is important to take care of your he alth, preventing the development of diseases of the musculoskeletal system.
In some cases, there is a subluxation of the shoulder after a stroke, which is manifested by quite severe pain. It is very important to provide timely assistance to the patient and carry out rehabilitation measures, since the recovery period will largely depend on this.
A feature of this condition is that it is impossible to eliminate pain in the joint with the help of analgesics, as well as other drugs. In addition, there is severe muscle weakness.
How to treat shoulder subluxation after a stroke, only the attending doctor can determine after the diagnosis. However, it is very important to keep the affected area immobile to prevent complications. After eliminating the acute period, you need to gradually develop the hand. For this, the doctor prescribes physiotherapy. Antidepressants and anticonvulsants are also indicated. The result can be seen only after a month of treatment.
First Aid
How to treat a subluxation of the shoulder, only the doctor can decide after the diagnosis, however, if a violation is suspected, it is important to provide the firsthelp. Vessels can be squeezed or blood circulation is disturbed, so you need to act very quickly. When providing first aid, you need:
- ensure complete rest of the limb;
- apply a cold compress;
- put a roller between arm and armpit;
- apply a fixing bandage, tying the injured limb to the body;
- give painkillers;
- take to hospital.
It is very important to act quickly but be careful not to hurt or aggravate the damage.
Reduction procedure
Treatment of habitual subluxation of the shoulder without surgery is carried out by reduction. It can be closed and open. The first option is performed under local anesthesia. To do this, the affected area is chipped with novocaine. To relax the muscles, a muscle relaxant is injected intramuscularly, and if the pain is very severe, then a narcotic analgesic will be required. An old habitual subluxation is removed under general anesthesia.
The most common ways of repositioning the joint are considered to be such as Hippocrates, Janelidze, Kocher, Mukhina-Mota. Which one is used depends largely on the type of damage.
Treatment after reduction is to immobilize the shoulder. This is necessary to fix the articulation in the desired position, heal the capsule and prevent relapses. A special bandage or splint is applied to the arm for a month. As soon as the joint assumes the correct position, all signs of injury will immediately disappear.
Important strictlywithstand the required period of wearing the bandage, even if swelling, pain and other symptoms have passed. The joint capsules do not heal if the immobilization of the shoulder was stopped earlier. This provokes a habitual dislocation with subsequent damage to nearby tissues.
Medications
To eliminate the painful symptoms of shoulder subluxation, treatment involves the use of medications. Doctors prescribe non-steroidal anti-inflammatory drugs in the form of gels and ointments for external use.
In the first 3 days, when swelling and pain in the limbs are significant, injections of Diclofenac and its analogues are indicated. During the recovery period, you will need to take chondroprotectors and vitamin-mineral complexes.
Physiotherapy techniques
Treatment of subluxation of the shoulder joint includes physiotherapy, in particular, such as:
- laser therapy;
- inductothermy;
- thermal wraps with paraffin or ozocerite;
- electrophoresis;
- massage;
- magnetotherapy.
At home, you can apply dry compresses with heated s alt or sand. The use of heat is allowed no earlier than 3 days after the injury. The use of a blue lamp is also effective, as well as baths with decoctions of medicinal herbs or sea s alt. All of these techniques have the following effect:
- normalize metabolism and blood circulation in tissues;
- restore joint mobility;
- accelerate the recovery process;
- eliminate the symptoms of inflammation.
You can also do a light massage by lightly pinching or stroking the injury.
Therapeutic gymnastics
To restore the motor functions of a limb after a subluxation, it is recommended to perform certain exercises, in particular, such as:
- shrugs;
- rotational movements;
- wave hands;
- setting hands clasped behind the head;
- exercise with stick or ball;
- movements with arms bent at the elbow.
Exercises should be done without applying force to the shoulder joint, as otherwise, there may be a recurrence of the injury.
Operating
If timely assistance is not provided to the victim, then pathological changes in the periarticular tissues will only worsen, the shoulder will lose its mobility, and the frequency of dislocations will also increase.
In this case, the damage can be repaired only during the operation, since neither immobilization nor massage can give any results. Such treatment significantly increases the rehabilitation period.
The operation is performed with fixation of the head of the humerus with sutures and special needles in the articular cavity. After the intervention, anti-inflammatory drugs and non-narcotic analgesics are required.
Possible Complications
Shoulder subluxation is a fairly seriousdamage. Incorrect treatment can lead to complications such as:
- nerve damage;
- joint instability;
- relapse even after the slightest injury;
- limited range of motion;
- degenerative joint changes.
A complication is also considered a fracture of the neck of the shoulder with subluxation, which requires complex therapy. Treatment must be carried out only by a doctor, since improperly performed therapy threatens with very serious consequences.
Prophylaxis
To avoid subluxation of the shoulder joint, it is recommended to strengthen the ligaments and muscles of the upper limbs daily through special exercises. You also need to adjust your diet, exclude fried, fatty and s alty foods, alcohol. It is advisable to include foods containing vitamin C and collagen in your usual diet.
It is important to lead an active lifestyle, move as much as possible. When sitting, you need to take breaks, stretch and warm up. All injuries and bruises of the shoulder should be treated in a timely manner.
