Dislocated Shoulder and Separated Shoulder

They're easy to confuse. But a dislocated shoulder and a separated shoulder are two distinct injuries. Here's the rundown.

  • Dislocated shoulder. In this injury, a fall or blow causes the top of your arm bone to pop out of the shoulder socket. Unlike a lot of joints in your body -- your elbow, for instance -- the shoulder is incredibly mobile. You can twist and move your upper arm in almost any direction. But there's a price for this ease of movement. The shoulder joint is inherently unstable, prone to slipping out of place.

    In severe cases of dislocated shoulder, the tissue and nerves around the shoulder joint get damaged. If you keep dislocating your shoulder, you could wind up with chronic instability and weakness.

  • Separated shoulder. Despite the name, this injury doesn't directly affect the shoulder joint. Instead, a fall or blow tears one of the ligaments that connects the collarbone to the shoulder blade.

    Since it's no longer anchored, the collarbone may move out of position and push against the skin near the top of your shoulder. Although separated shoulders can cause deformity, people usually recover fully with time.

You might get a separated shoulder or a dislocated shoulder by:

  • Falling onto your shoulder, especially on a hard surface
  • Being hit in the shoulder
  • Trying to break a fall with your hand

Dislocated shoulders can also result from a sharp twisting of the arm.

Sports that pose a higher risk of these two injuries are:

  • Football
  • Hockey
  • Rock climbing
  • Rugby
  • Soccer
  • Skiing
  • Volleyball

 

What Does a Dislocated Shoulder or Separated Shoulder Feel Like?

Symptoms of a dislocated shoulder are:

  • Pain in the shoulder and upper arm that hurts more when you move the area
  • Deformation of the shoulder -- a bump in the front or back of your shoulder, depending on how the bone has been dislocated

Symptoms of a separated shoulder are:

  • Intense pain as soon as the injury occurs
  • Tenderness of the shoulder and collarbone
  • Swelling
  • Bruising
  • Deformed shoulder

To diagnose a separated shoulder or dislocated shoulder, your doctor will give you a thorough exam. You may need X-rays to rule out broken bones and other conditions.

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What's the Treatment for Dislocated Shoulder or Separated Shoulder?

Dislocated shoulders need to be treated right away. Your doctor will need to move the arm bone back into the shoulder socket. Since the joint will get more swollen and more painful by the minute, the sooner the better. Once the arm bone is back in the socket, some of the pain will go away.

After the shoulder bone is repositioned, you can use conservative treatment to reduce pain and swelling. The same treatment would also be used for a separated shoulder.

To treat either injury, you should:

  • Ice your shoulder to reduce pain and swelling. Do it for 20-30 minutes every three to four hours, for 2 to 3 days or longer.
  • Use a sling or shoulder immobilizer to prevent further injury until you get medical treatment. Then follow the doctor's advice about whether or not to use a sling.
  • Take anti-inflammatory painkillers. Non-steroidal anti-inflammatory drugs, or NSAIDs such as ibuprofen (Advil, Motrin) or naproxen (Aleve), will help with pain and swelling. However, these drugs may have side effects, like an increased risk of bleeding and ulcers or heart attacks and strokes. They should not be used for extended periods of time, unless your doctor specifically says otherwise.
  • Practice stretching and strengthening exercises if your doctor recommends them.

Most of the time, these treatments will do the trick. But in rare cases, you may need surgery.

Surgery for severe separated shoulders is sometimes needed to repair the torn ligament. Afterwards, you will probably need to keep your arm in a sling for about six weeks.

For a severely dislocated shoulder, surgery is sometimes needed to correctly position the bones. If you keep dislocating your shoulder, surgery to tighten the tendons surrounding the joint may help.

When Will My Dislocated or Separated Shoulder Feel Better?

How quickly you recover depends on how serious your shoulder injury is. Separated shoulders may heal over a period of 6 weeks. Dislocated shoulders may take longer -- more like 3 to 12 weeks. But these lengths of time are just approximations. Everyone heals at a different rate.

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Some symptoms, like stiffness, may linger for a time. A separated shoulder can sometimes leave a permanent, but painless, bump on your shoulder.

Once the acute symptoms are gone, your doctor will probably want you to start rehabilitation. This will make your shoulder muscles stronger and more limber. It will both help you recover and reduce the chances of future shoulder injuries.

You might start with gentle stretching exercises that become more intense as you get better. But don't start exercising without talking to your doctor first.

Whatever you do, don't rush things. Ease back into your sport. If you play baseball, start by tossing the ball and work up to throwing at full speed. People who play contact sports need to be especially careful that they are fully healed before playing again.

Don't try to return to your previous level of physical activity until:

  • You can move your injured shoulder as freely as your uninjured shoulder.
  • Your injured shoulder feels as strong as your uninjured shoulder.

If you start using your shoulder before it's healed, you could cause permanent damage. Getting back in the game early is not worth the risk of a lifelong disability.

How Can I Prevent a Dislocated Shoulder or Separated Shoulder?

Getting a separated shoulder or a dislocated shoulder is painful and debilitating. So do what you can to reduce your chances of getting either of these injuries.

Here are some tips:

  • If you feel any shoulder pain during physical activity, stop.
  • Exercise and stretch your shoulder muscles regularly.
  • Ice your shoulder after physical activity if you have had a shoulder separation before.
  • Use protective padding to protect from falls if you are at risk of a shoulder dislocation.
WebMD Medical Reference Reviewed by Jennifer Robinson, MD on September 21, 2015

Sources

SOURCES:

American Academy of Orthopedic Surgeons: ''Dislocated shoulder;'' ''Shoulder Separation.'' 

Rouzier, P., The Sports Medicine Patient Advisor, second edition, SportsMed Press, 2004.

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