How to Reduce a Dislocated Shoulder

Patients who sustain a shoulder dislocation will need to have the shoulder repositioned, a process called "reducing a shoulder.'" Almost everyone who dislocates for the first time will require assistance reducing the shoulder. People who have dislocated their shoulder many times may be able to easily reduce their shoulder.

While medical attention should be sought any time a shoulder dislocation is treated, sometimes it's impossible. Hikers, kayakers, mountaineers, and other outdoor athletes may be days from medical help, and these people should know how to treat a shoulder dislocation.

Common symptoms of a shoulder dislocation include:

• Sudden pain around the shoulder
• Deformity of the shoulder
• Holding your forearm because of shoulder pain

If you think you have dislocated your shoulder, you should seek medical attention if at all possible. If no medical help is available, proceed with reducing the shoulder.

In a healthcare setting, medications are used to relax the patient, but sometimes on an athletic field or in the wilderness, that may not be possible. If the muscles around the shoulder are tense, reducing the joint becomes a near-impossible task.

Reducing a shoulder is not accomplished well if there is anxiety, commotion, and chaos. Creating a quiet setting, where a patient with a dislocated shoulder can relax, is by far the most effective way to begin the job of repositioning the joint.

1. Have the patient lie down. The patient should lie down in a comfortable position. Allowing the muscles around the shoulder joint to relax is the key to reducing the joint. If anesthesia is unavailable, the patient must be kept as comfortable as possible to allow the muscles to relax.
2. Take some deep breaths and relax. Again, the key is to relax. Take a few minutes to allow the injured person to rest. Take a few deep breaths and relax as best possible. Patients who are crying, writhing, or upset need to relax before proceeding with treatment.
3. Reach the dislocated arm out to the side. Start by reaching the injured arm out to the side and over your head. The elbow should move away from your side. The arm can be supported by a helper, although this is not necessary. This should be a slow movement, and pain should be a sign to slow down. This does not need to be painful.
4. Rotate your hand behind your head. Once the arm is over the level of your shoulder, rotate the hand behind your head. The movement should be similar to scratching the back of your neck. Make sure this is done slowly and try to keep relaxed.
5. Reach for your opposite shoulder. Once your hand is behind your head, reach for your opposite shoulder. As you are reaching, the shoulder will, hopefully, pop back into place. You should feel a sudden relief of your pain although it is normal to have continued discomfort in the injured shoulder. Shoulder movements should be much less painful once it is in the proper position.
6. Seek help when possible. Potentially serious problems are associated with shoulder dislocations and treatment to reposition the shoulder. That is why these should be treated by trained personnel if possible. If a shoulder dislocation must be reduced "in the field," seek medical attention as soon as possible.

• The technique should be done slowly. It is important to move slowly and relax, avoiding the temptation to tense your muscles.
• A helper can assist you, but it is not necessary. The helper should gently support your arm through these movements.
• If you forget the movements, think of a baseball pitcher winding up to throw a ball—that's a general movement.
• Always seek medical attention first, if possible. These maneuvers should only be done if medical assistance is unavailable.