1. Important to Get It Back In the Joint ASAP
It is important to pop the shoulder back in as soon as possible. The longer the ball is off the plate, there is higher risk for nerve or vessel damage. The muscles will also spasm, making it harder to relocate. Sometimes, in a fresh dislocation, before the muscles have had a chance to spasm, the shoulder will pop back in by itself. It is recommended to see a healthcare specialist right away. You will want to see an emergency room physician. An emergency room physician is trained in reducing the shoulder back into place. It it not advisable to try to pop it back in yourself, especially forcefully, a la Mel Gibson in the "Lethal Weapon" movies. You can definitely do further damage. Oftentimes, a painkiller, injection or even light anesthesia are required to relax the muscles enough to reduce the shoulder.
2. X-rays and MRIs May Be Necessary
After the shoulder is reduced, X-rays will be taken to confirm that the shoulder is back in place. Later, you will likely see an orthopedist who will determine if you need an MRI. The MRI can show structural damage that may have occurred, such as labral tears, cartilage defects, bone bruises/fractures, and ligament or tendon tears.
3. Expect to Wear a Sling
After the shoulder is reduced, you will be in a sling or shoulder immobilizer for usually a few weeks until the soft tissues calm down. Traditionally, this will be a regular sling around your neck, which places your arm across your belly, in internal rotation. More recently, a Japanese group led by Dr. Itoi, suggested that immobilizing the shoulder in external rotation may better allow the tissues to heal in their proper place. However, the jury is still out on this claim.
4. Physical Therapy Is a Possibility
After your shoulder calms down a bit, your doctor may send you to physical therapy to regain your range of motion and strength, while protecting the shoulder from re-dislocating. This is typically the first step for all dislocators, young or old, first time or several times.
5. Surgery May Be Required
If your shoulder keeps popping out, you may benefit from surgical stabilization of your shoulder. This can be done either with an open incision or arthroscopically. Suture anchors will be placed in the bone and the labrum reattached to the bone. Sometimes, if the shoulder joint capsule has been stretched out, the surgeon may choose to tighten up the capsule to prevent further dislocations. You will usually be in a sling anywhere from three to six weeks and then go through physical therapy afterward. The typical time frame for return to sports is four to six months.
