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Shoulder
> Shoulder Subluxation
What is Shoulder Subluxation?
The three bones that
make up your shoulder – the collarbone (clavicle),
upper arm bone (humerus), and shoulder blade (scapula)
– are held in place by muscles, ligaments, and
tendons. When these tissues have been damaged through
acute injury or repetitive stress, your shoulder can
become loose and unstable. Shoulder subluxation is one
outgrowth of shoulder instability. When your shoulder
subluxates, your upper arm bone comes part of the way
out of the shoulder socket (glenoid), but, unlike during
a shoulder dislocation, it is able to return to its
normal position.
If you have dislocated your shoulder,
you are at greater risk for shoulder subluxation if
the ligaments and tendons that make up the shoulder
joint capsule have not fully healed and are unable to
keep your shoulder in place. Dislocations are traumatic
injuries that can occur when the arm is extended away
from the body and is snapped back, such as when a football
player makes a tackle or a baseball player slides headfirst
into a base incorrectly. Overuse also can be a contributing
factor. Any sport that requires throwing or using an
overhead motion, such as baseball, tennis, swimming,
volleyball, or water polo, can increase the risk of
shoulder subluxation. In addition, some people may be
more prone to shoulder instability and possible subluxation
if they suffer from general laxity, or looseness, of
the joints.
There usually are three parts to an
orthopedic evaluation: medical history, a physical examination,
and tests that your physician may order.
Your physician will ask about your activities, which may
have caused your shoulder pain. You will be asked when
the soreness or pain began, where in your shoulder it
occurs, how long it lasts, and what lessens or worsens
it. If you have had any prior shoulder injuries, your
physician will ask about treatments you have tried in
the past. Physicians also typically ask about other conditions,
such as arthritis, diabetes, and allergies, and medications
currently being taken. You also may be asked about your
athletic goals as well as the physical requirements of
your job – information that will help your physician
decide what treatment might be best for you.
PHYSICAL EXAM
Your physician will palpate, or feel with the fingers,
your shoulder for areas of tenderness, and may assist
you in moving your shoulder through its whole range of
motion to check for any pain or abnormalities. During
this examination, you may feel as though your shoulder
is going to come out of its socket. This is a sign of
instability, but it will not lead to a dislocation except
in rare cases. In some cases, your physician may choose
to examine your shoulder while you are under anesthesia
and your muscles are relaxed.
The following tests may be ordered
by your physician:
 X-rays,
which can aid in diagnosing tumors or fractures that
may be contributing to your shoulder pain.
Blood
tests, to check for any infections or systemic disorders.
Magnetic
resonance imaging, in which dye is injected into the
joint, can reveal damage to ligaments and tendons.
Injection
of a local anesthetic into your shoulder, to test for
impingement, or pinching, of the rotator cuff.
An
arthrogram, in which dye is injected into your shoulder
and X-rays are taken, may be used on rare occasions.
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