Q: I've dislocated my shoulder twice. What can I do to prevent this from happening again?
A: When a shoulder is dislocated, the ball-shaped portion of the upper arm (the humerus) has moved out of its normal position within the cup-shaped socket. The shoulder is somewhat prone to dislocation because it has the largest range of motion of any joint in the body. While that's handy in allowing enormous mobility to the arms, it also makes the shoulder less stable.
In most cases, a shoulder dislocates due to trauma, such as sports injury, a fall or motor vehicle accident. Some people are prone to dislocations. For example, they may have been born with an abnormal joint, or they may have loose ligaments.
Preventive strategies depend upon the circumstances of the initial episodes. For example, if you dislocated your shoulder due to a sports injury, another dislocation may be avoided with a change in technique or playing style and protective gear. For people with poor balance, use of a cane can help avoid falls.
Exercises to strengthen and stabilize the shoulder can be helpful. Your doctor may recommend that you work with a personal trainer or a physical therapist with experience in shoulder dislocations. However, returning to normal activities too soon can make repeated dislocations more likely, so ask your doctor for recommendations about how to balance rest and exercise. In some cases, surgery may be recommended to improve stability and reduce the chances of future dislocations.
People who've experienced shoulder dislocations are somewhat prone to recurrence. It's not always possible to prevent such dislocations from repeating. In such cases, the best advice may be the easiest to give and the hardest to follow: Be more careful.
(Robert H. Shmerling, M.D., is Associate Professor of Medicine at Harvard Medical School and Clinical Chief of Rheumatology at Beth Israel Deaconess Medical Center, Boston, Mass.)
(For additional consumer health information, please visit http://www.health.harvard.edu.)
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