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Published on October 20, 2020

man with hand on shoulder in pain

How Orthopedic Specialists Help You Recover From Shoulder Injuries

Our shoulders are amazingly versatile joints, but falls, trauma and miscues in some sports can lead to injuries like shoulder dislocation and AC joint separation.

Most of us might mix these terms up, or not understand how this super-flexible part of our body works. Mark Hagy, MD, Avera Orthopedics physician, spells out the facts on what happens – and how providers treat these common injuries.

Shoulder Injuries Start with Trauma

When a farmer or rancher falls off equipment, shoulder injuries can occur. They also arise from sports, auto accidents, falls from a high point or other trauma-causing events.

“A dislocated shoulder happens when the bone of the upper arm (humerus) comes out of the socket where it normally sets,” said Hagy. “A separated shoulder is actually an AC joint separation, as it affects the acromioclavicular or AC joint. It’s a tiny joint at the top of the shoulder held together by ligaments.”

Shoulder Dislocation – Pain and Odd Position

A dislocated shoulder will likely hurt so much, you’ll seek emergency care. The arm or the shoulder will be in an abnormal position, and there may be a dent or dimple in your skin just below the shoulder.

“Some people may be able relocate or ‘pop’ the joint back into place, while most will go to an emergency room,” Hagy said.

Here’s what happens at the emergency room:

  • You would receive medication to help you relax
  • The care team will usually relocate the arm bone (humerus) by popping it back into place
  • The shoulder will be immobilized to allow the damage to heal
  • Exercises will be assigned to speed your recovery
  • You’ll follow up with your orthopedic team about two weeks later

Depending on the progress of healing, most patients continue more physical therapy-type exercise. Additional appointments will be scheduled, usually six and 12 weeks later. People who suffer a dislocated shoulder are often likely to have them again, and they would require further treatment.

AC Joint Separation – Bump and Limited Motion

Of the five types of AC joint separation, types 1 and 2 are the mildest ones, and are considered to be sprains. Serious AC joint separations – types 3, 4 or 5 – are worse, and require more treatment.

In all cases, there will be a big bump in the shoulder area.

“We use X-rays to see the level of separation, and in less-serious cases, you’ll have your arm in a sling or a figure-8 brace for two to six weeks,” said Hagy. “In more severe separations, operative intervention is likely needed. Each patient is different, and physical therapy is again an important part of treatment and recovery.”

These injuries can include damage to ligaments that surround the collarbone and shoulder blade.

Shoulder Treatment Starts Conservatively

Since slings or braces restrict the movement of the injured area, they help your recovery after either an AC joint separation or a dislocation, along with gentle shoulder movement exercises.

Physical therapy will be a part of the fix, too, along with anti-inflammatory medication like Tylenol, ice and rest.

“All of these approaches are the main focus of treatment at its beginning,” said Hagy. “The follow-up appointments are important, too, because we can see how you’re progressing and make adjustments in approaches as they are needed.”

Orthopedic Surgical Solutions

When orthopedic experts determine a serious dislocation or AC joint separation has led to damage that restriction, time and exercises won’t help, outpatient surgical procedures may be used to repair ligaments or other damage.

“Both injuries are common, and if appropriate care is applied, outcomes are generally good with our without an operative procedure,” Hagy said. “The good news is there are orthopedic approaches we can use to treat any of them.”

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