Shoulder dislocations in prep football players
The shoulder joint has the greatest range of motion of any joint in an athlete’s body, and subsequently is particularly at risk to a dislocation injury.
This is an all too common story in high school football athletes. Research tells us that a high school athlete who has a first time shoulder dislocation injury, and is treated non-operatively with an immobilizer then physical therapy, has an 85-95% chance of suffering another dislocation injury within a year of returning to their sport. The good news is there are new treatment approaches available to significantly decrease this high risk.
What is a shoulder dislocation? A shoulder dislocation occurs when the head of the humerus (the “ball”) becomes detached from the scapula (the “socket”) due to a traumatic injury which tears the capsule and ligaments holding the ball in the socket.
Typically in high school football, the mechanisms of this injury are when a tackler uses poor form and “arm tackles”, or when a player falls on an outstretched arm, or a quarterback is in the throwing motion and gets their arm hit from the front. Ninety-five percent of shoulder dislocations occur when the "ball" comes out forward (anterior) to the socket.
Symptoms of a shoulder dislocation include: severe pain, inability to move the arm, self-splinting the arm by the side, loss of the contour of the deltoid musculature (due to the ball dropping down and forward), and complaints of a dead-arm feeling.
In some cases, the "ball" will spontaneously relocate back on the socket, relieving pain and in many cases lead the athlete to believe they suffered a minor injury.
If the "ball" is stuck in a dislocated position, the best medicine is to get appropriate medical help immediately to reduce the dislocation and prevent any long-term injury to the neurovascular tissues in the shoulder and arm. This includes x-rays to look for fractures (fractures of either the ball or socket as they collide when the shoulder dislocates) and may include an MRI if there is a high suspicion of internal derangement injury to the rotator cuff or labrum cartilage (which surrounds the socket).
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