 Shoulder dislocations are usually caused by trauma. The trauma may involve a
sporting injury, motor vehicle accident or a fall. For anterior shoulder
dislocations, the arm is usually away from the body, sometimes with the hand
overhead. For posterior dislocations, the arm is usually is front of the body
reaching forward.
 Shoulder dislocations can be extremely uncomfortable, when they
occur.
Generally, when the shoulder is reduced, or placed back in joint, the
pain improves
significantly. For some patients, shoulder dislocations are not
very uncomfortable
while for others it can be extremely painful. Some patients
are able to put their
shoulder back in joint on their own, while others require
medical attention in
order for their shoulder to be reduced. For patients in
whom the shoulder dislocations
become recurrent, they may limit their
activities to avoid further dislocations.
 In general, surgery is required to prevent shoulder dislocations, once
the
dislocations have become recurrent. Patients who are young and who
participate
in contact athletics are at very high risk of recurrence even after
a first shoulder
dislocation. In such individuals, surgery may be considered
after the first dislocation.
The surgery involves repairing the torn ligaments
to the bone, and in some cases,
also tightening (or shortening) the ligaments
of the shoulder to prevent the
shoulder from dislocating. The surgery can be
doe arthroscopically or using an
open approach. The selection of the technique
for surgery depends on the type
of pathology or injury involved. The surgery is
usually done arthroscopically.
 After surgery, the arm is kept in a sling for three to four weeks. Some
gentle
exercises may be started during this time. When the sling is
discontinued, more
aggressive physical therapy is undertaken to restore motion
and strength. Full
return to athletics in all sports is generally at six months
following the surgery
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