Shoulder instability and dislocation in children

What does shoulder instability and dislocation in children mean?

Shoulder instability occurs when the joint is loose, allowing the upper arm bone to move around too much in the socket. When an unstable shoulder fully slips out of its socket, it’s called a dislocation.

We advise parents to treat shoulder dislocation as soon as possible, and provide a comprehensive range of options. Early intervention helps avoid further shoulder damage and ensures a faster return to daily activities like sports.

What are the signs and symptoms of shoulder instability and dislocation in children?

Common symptoms of shoulder instability include:

• Pain in shoulder joint

• Feeling of shoulder “giving out” or being “loose”

• Repetitive shoulder dislocations

When shoulder instability becomes chronic, shoulder dislocations happen more often.

Signs and symptoms of shoulder dislocation include:

• Pain

• Swelling

• Warmth and redness

• Bruising

• Deformity in the shoulder joint

• Difficulty moving the arm

Sometimes, dislocated shoulders may temporarily move back in place. If this happens, your child may still have shoulder damage that needs medical attention. If you suspect a shoulder dislocation, consult your child’s physician right away.

How is shoulder instability and dislocation in children diagnosed?

Diagnosing shoulder instability or dislocation starts with a full assessment and evaluation, so that our physicians can develop a care plan for your child’s symptoms.

Tests may include:

• Physical exam: Tests movement, appearance and sensation in your child’s arm and shoulder muscles

• X-ray: Uses invisible electromagnetic energy beams to take detailed images of the shoulder’s bones

• MRI (magnetic resonance imaging) scan: Uses magnetic fields and radio waves to take detailed pictures of the shoulder joint, checking for tears in the ligaments, tendons or cartilage

• Electromyography (EMG) scan: Uses electrodes to transmit or detect electrical signals to assess the health of the muscles and determine muscle damage

What are the causes of shoulder instability and dislocation in children?

Common causes for shoulder instability and dislocation include:

• Falling on an outstretch arm

• Poor throwing technique

• Excessive overhead activity such as throwing, gymnastics and swimming

• Previous shoulder injuries

• High level of flexibility in the joints

How is shoulder instability and dislocation in children treated?

Treatment for shoulder instability and dislocation depends on the severity of your child’s injury. Most often, our physicians can use therapies that avoid surgery. When a child is treated early, our physicians and therapists can often prevent more serious problems such as dislocations.

Nonsurgical treatments

• Rest, ice, compression and elevation (RICE)

• Medication to help manage pain and swelling

• Activity modification

• Physical therapy (PT) and rehabilitation

• Splinting or casting to immobilize and promote healing

• Reduction, a procedure in which your child’s physician places the shoulder joint back in its proper position so it will heal correctly. Your child will receive sedation for comfort during the procedure.

Surgery

For chronic shoulder dislocation, we may recommend surgery to repair damaged muscles, tendons or ligaments.