In anterior glenohumeral dislocation, the head of the humerus is forced out of it’s articular capsule in an anterior direction past the glenoid labrum and then downward to rest under the coracoid process (Arnheim and Prentice, 1997).
Mechanism of injury
This injury usually occurs when there is direct impact to the posterior or posterolateral aspect of the shoulder. Another mechanism is the forced abduction combined with external rotation and extension that forces the humeral head out of the glenoid cavity.
In layman’s terms this means that your arm, which may be extended or partially so, is forced unnaturally in a backward direction with high force or impact. The result of this action is that the top of the upper arm that is in the shoulder joint is forced out of the joint, causing intense pain and discomfort. This is a common injury that occurs primarily during the action of tackling in rugby where the impact is not on the shoulder of the tackler but primarily on the outstretched arm of the tackler.
Coupled with the above injury is excessive injury to the soft tissue surrounding and encapsulating the shoulder. This includes tearing of the capsule and ligaments surrounding the shoulder as well as possible damage to the tendon and rotator cuff muscles and excessive bleeding in the joint.
It is important that anyone who encounters this kind of injury NOT try to “reduce” or put the shoulder back in the socket. It is imperative that a doctor does this, as there are certain procedures and specific methods that need to be followed. Often, muscle relaxants are administered to the athlete before reduction is attempted. In certain instances fractures are associated with dislocations and this only serves to further emphasise the fact that urgent and immediate medical attention from professionals is imperative.
One of the most obvious symptoms is a flattened contour of the shoulder. You may even be able to witness the head of the bone of the upper arm (humerus) under the process of the shoulder. The athlete will always be very sensitive to touch or movement of the arm and will always hold the arm folded in front of the body often cradling it in the other unaffected arm. As they say, an athlete always knows when there has been a dislocation of the shoulder.
Time out of action
With this injury, extensive rehabilitation and strengthening are required before the athlete may return to active participation. While after the initial stages the athlete may be symptom and pain free, they will still be required to go through intensive rehabilitation and strengthening of the shoulder. In certain severe instances an operation may be necessary. There are some who say six to eight weeks out of action may be realistic although time periods of up to three months have been noted. – (Conrad Booysen, Biokineticist)
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