Understanding Subluxated and Dislocated Shoulder Injuries

After returning from season-ending injury last year, Red Sox relief pitcher Carson Smith landed on the disabled list again last week after suffering a right shoulder subluxation. Reports say it has the potential to be a “major injury,” without an exact timeline for returning to the field.

Pitchers are at-risk for muscle fatigue due to repetitive motion, which often plays a role in partial dislocation, also known as subluxation, as well as full dislocation. Both injuries are painful, and can cause feelings of weakness, numbness and tingling.

“By nature, your shoulder allows a large range of movement. Both subluxation and dislocation are significant because once either injury happens, it’s likely it could happen again,” says Preeti Shastri, MD, a sports medicine physician at BIDMC. “Partial or full dislocation can cause damage to ligaments, nerves, cartilage or bone.”

“Because every injury is unique, your doctor will need to perform a series of tests to determine the cause of your shoulder’s instability,” Shastri adds. “There’s no one-size-fits-all treatment for dislocated shoulders.”

Immobilizing the joint with a sling immediately after subluxation is usually the first step to reducing the chance of dislocation occurring again. “A sling can keep you a bit more comfortable and prevents you from using your arm in ways that can strain your shoulder,” Shastri says.

Your doctor may also suggest physical therapy and strengthening exercises. “Beginning therapy right away can help you avoid stiffness. While strengthening the muscles around your shoulder won’t prevent recurrence, it definitely helps in the overall rehabilitation of the injury,” Shastri says.

Some injuries related to subluxation or dislocation—such as a torn labrum (cartilage) or rotator cuff—may require surgery.

“Tearing your labrum or rotator cuff is common with a shoulder dislocation,” Shastri says. “These usually involve painful popping or snapping with movement. If your symptoms persist despite already trying more conservative treatments like physical therapy, I would refer you to an orthopaedic surgeon for further evaluation.”

Like most of us, professional athletes often want to rehab an injury as quickly as possible, especially if they’re aiming to get back on the field before the end of a season. By carefully following a prescribed treatment plan, you can help prevent a recurring injury and stay more active in the long-term.