If you saw Dwayne Wade dislocate his shoulder earlier this basketball season you probably heard that collective "Ouch!" from everyone who saw the replay. So what happens if you dislocate your shoulder playing basketball or from some other sport?
The first thing you should do is seek medical attention. If there is an Orthopaedist on site, perhaps he may try and "reduce" or put back in place your shoulder. However, it is best to go to the local emergency department for pain medications and local anesthesia during the reduction. Most typically, "conscious sedation" is given. This is a combination of strong intravenous pain killers with a sedative that basically puts you to sleep very briefly. If a muscle relaxant is also given, it will make the reduction maneuver easier.
If you do dislocate your shoulder, it is important to get it put back in place as soon as possible. Within 6 to 8 hours is ideal because after that period the swelling becomes cumbersome and makes the reduction difficult. If your shoulder is not reducible in the emergency department it will need to be reduced under general anesthesia in the operating room. There are risks associated with general anasthesia so this is not the ideal way to get your shoulder reduced.
Once your shoulder is put back in place, you should keep it in an arm immobilizer or a "sling and swathe". Immobilizing the shoulder for a short duration of time is essential until you can be examined by a physician once the swelling has gone down.
There is some debate about whether a first-time dislocation should be treated conservatively or should be stabilized via shoulder surgery. Recent studies following patients over a 25-year period after their dislocation show that non-operative treatment of a shoulder dislocation in people under 40 years of age provides good long term results. If you are a high-performance athlete or older than 40, perhaps surgery will give you a better return to high function. Either way, it is important for you to seek immediate medical attention, wear an immobilizer after the dislocation, and have proper follow up after initial treatment.
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