How to Reduce a Dislocated Shoulder

People who sustain a shoulder dislocation will need to have the shoulder restored to its correct position, a process referred to as "reducing the shoulder." If this occurs, you would not usually try to restore it yourself, but rather seek medical assistance to avoid damaging tissues, nerves, and blood vessels in and around the shoulder joint.

In some cases, this may not be possible. Hikers, kayakers, mountaineers, and other outdoor athletes may be days from help and should learn how to properly reduce a shoulder in the event of an accident.

If not treated in a timely manner, a dislocated shoulder may lead to potentially serious complications, including permanent nerve injury, avascular necrosis (bone death due to the impairment of blood flow), and the loss of joint mobility and range of motion.

Symptoms of Shoulder Dislocation

A dislocated shoulder is often unlike what you see in the movies. The signs may be overt or subtle. The dislocation can be partial (referred to as subluxation) or complete (luxation).

Common symptoms of a shoulder dislocation include:

• Sudden pain around the shoulder
• Deformity of the shoulder
• Holding the forearm due to shoulder pain

If you think you have a dislocated shoulder, you should seek medical attention as soon as possible. If no medical help is available, you can proceed with the reduction of the shoulder, albeit with extreme caution.

Step-by-Step Guide to Shoulder Reduction

In a health care setting, anti-inflammatory injections or muscle relaxants are common prescribed prior to a reduction, but, in the wilderness or a remote setting, these are usually not available. This is of concern, as the reduction of a joint is near-impossible if the muscles around the shoulder are tense and in seizure.

Therefore, the first and arguably most important step is to get the injured person to relax as much as possible prior to the reduction. Do not proceed if there is any screaming, panic, or chaos. Instead, create a calm environment, removing anyone who may be causing undue stress, anxiety, or agitation.

To reduce a dislocated shoulder:

1. Have the injured party lie down on their back in a comfortable position, allowing the muscles around the shoulder to relax as much as possible.
2. Allow the injured person to rest for several minutes, encouraging long, deep inhalations and exhalations rather than rapid breathing. It often helps to coach the individual to follow your breathing patterns until they settle.
3. To begin, slowly extend the injured arm out to the side, raising the arm gently and bending the elbow so that the palm of the hand touches the top of the head. The arm can be supported by a helper, although this is not necessary. Movements should be slow; pain is a sign to slow things down.
4. Gently rotate the hand behind the head.
5. Gradually move the hand from the back of the head down toward the nape of the neck (as if you were trying to scratch your neck).
6. Next, move the hand toward the opposite shoulder. As this is done, the shoulder should pop back into place, and immediate relief should be felt. Do not push, pull, or tug the arm.
7. If the joint doesn't pop back instantly, take several moments to relax, breathing in slowly and deeply, and try again. When fully relaxed, the chances of a successful reduction are good.
8. When the shoulder is back in its proper position, keep the upper arm to the side of the body with the forearm folded across the abdomen in a 90-degree position.
9. If it is comfortable to do so, place a towel or cloth under the injured forearm to create a sling, tying the ends over the opposite shoulder (one end to the front and one end to the back).
10. Seek medical assistance immediately. 

In such cases, bind a towel or cloth around the person's upper body to stabilize the shoulder in a comfortable position and seek immediate help.

A Word From Verywell

If the self-reduction of a dislocated shoulder is necessary, the keywords to remember are "slow" and "relaxed." Pain is a sign that you are either moving too quickly, the muscles are too tense, or there may be other injuries that you are unaware of.

It is far better to take as much time as reasonably needed before performing the reduction. Unless there is extreme pain, it often helps for the injured party to simply lie in a comfortable position, chat, and allow any panic to subside. A slow respiration rate is often the sign that you are ready to proceed.

After the shoulder is properly reduced, seek medical help even if everything seems 100% okay. There may be other problems that need tending to that only a doctor can diagnose. Pain control and shoulder rehabilitation efforts may also be needed.