Dr Bryan Betty: Dislocated shoulders

This week Chris Woakes the English cricket batting star dislocated his shoulder in the England-India test, then yesterday came out to bat with a dislocated shoulder at number 11 to try and save the test! Very brave stuff!  

 

What is a shoulder dislocation?  

• The shoulder is the most mobile joint in the body. 
• It’s a ‘ball and socket’ joint, however sockets aren’t deep enough so the joint is supported by tendons and muscles. 
• Occasionally the ball can come completely out of the socket – a dislocation. 
• It can dislocate forward, which is common, or backwards, which is less common. 

 

How do they happen and what are the signs?  

• Generally an accident that puts severe force on the shoulder can cause dislocation.  
• For example:  
  • Falling from ladder and holding on it.  
  • Collision in sport or falling onto an outstretched arm.  
  • Car accidents. 
• Some people have very flexible shoulders and can dislocate with simple things like rolling over in bed, hanging out washing.  
• Effects: severe pain, unable to move the shoulder, occasional numbness down arm. 
• You can see the deformity – can see the ball out of the socket, bulging out.  

   

What do we do about it?  

• See a doctor who will examine the shoulder.  
• An Xray to make sure it is not broken.  
• Then pop it back into place with light sedation or anaesthetic.  
• Then keep the arm in a sling for 1-2 weeks, avoiding lifting or using the shoulder for six weeks. It can take up to 3-4 months to fully heal.  
• Physio is often important to strengthen the shoulder and get moving.  

   

Are there any complications?  

• You can fracture the shoulder.  
• Can tear cartilage (or lining) of the shoulder.  
• Sometimes the tendons and muscles supporting the shoulder tear – call this a rotator cuff tear.  
• Nerve damage can occur.  
• Sometimes requires surgery.  
• Can become recurrent and requires surgery to stop it popping out: orthopaedic surgeon. 

 

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Episode Transcript

Speaker 1 (00:07):
You're listening to the Saturday Morning with Jack Team podcast
from newstalks'd be quarter.

Speaker 2 (00:13):
To eleven on news talks, He'd be yes. Test cricket
fans would have delighted in the drama of the Final
Test between England and India. In the last session, English
cricketer Chris Wokes walked to the crease with a dislocated
shoulder in a sling. He came out to bat. Fortunately
he didn't really have to actually do any batting. Well
unfortunately for his team that lost the game. But it

(00:35):
was a moment of drama, a moment of courage, a
moment best avoided if possible. And doctor Brian Betty is
here with his advice on doing just that.

Speaker 3 (00:42):
Calder Brian, Oh, kiro Jack, nice to be Here're nice
to be chatting.

Speaker 2 (00:46):
So what is the shoulder disication? That start with the basics?

Speaker 3 (00:49):
Yeah, yeah, So look, look, the shoulder is the most
mobile joint in the body and it's called a ball
in socket. So the top of the upper arm has
got a ball on it and it fits into a socket. However,
the socket isn't quite deep enough and it has to
be supported by tendons and muscles, so Occasionally the ball
can come completely out of the socket, and we call

(01:10):
that a dislocation. Now commonly it dislocates forward, so the
ball comes out forward. Occasionally it dislocates back back, and
we call that posterior. But it's it's a very very
significant injury if it occurs.

Speaker 2 (01:24):
Yeah, it's really nasty and often often the problem is
that once you've had it, you kind of more susceptible
to having it again, right yeah, yeah.

Speaker 3 (01:33):
So yeah, so so if it happens once, it happens again.
Often that's the case.

Speaker 2 (01:37):
So my brother has dissicated shoulder, oh I don't know,
three or four times, quite a few times and needed
surgery and stuff. But I remember he did it the
first time playing rugby, and then the second time he
was going for a run and he got swooped by
a magpie and he and he thrust his hand in
the ear as you do kind of reflex, and justicuted

(01:58):
his shoulder. It was an absolute fiasco. Yeah.

Speaker 1 (02:00):
Yeah.

Speaker 2 (02:01):
Anyway, so aside from being swooped by a magpie, how
do they happen?

Speaker 1 (02:05):
What are the same?

Speaker 3 (02:07):
Well, look, generally it's an accident or trauma that causes
a dislocation, So it's some sort of force on the
shoulder that allows the socket the ball to pop out
of the socket. Now, now examples of that are, you know,
falling from a ladder and you grab onto the ladder
and hold and wrenches the shoulder, it pops it out.
Sport is really really common. So as we saw with
Chris Wokes and your brother's example with rugby, often a

(02:29):
collision in sport or falling onto an outstretched arm will
pop it out. And I suspect that's what happened with
with Chris in his game car accidents. Obviously, direct trauma
is the other thing that can actually cause it. The
other thing you tapped into is some people have very
very flexible shoulders and they can actually dislocate with the
simplest thing, so rolling over in bed or stretching up

(02:52):
to put out the washing that the shoulder can pop out.
And I suspect what happened with your brother is because
he'd had a couple of dislocations, the tendons and muscles
are a bit weak and that magpie sweep and he
puts up his arm, bang out pops the shoulder. In
those situations, Yeah, you do need surgery to try and
try and fix it.

Speaker 2 (03:10):
We muscles. I think that'll be the weak muscles, my brother. Yeah, situation. Yeah,
so what do we do about it?

Speaker 3 (03:16):
Yeah? Look, I mean if it happens, look, it tends
to be incredibly painful. You're not able to move the shoulder. Occasionally,
there's numbness down the arms. So and if you look
at the shoulder you can see that on one side
there will be a bulge where it's popped out or
a depression where it's it's gone backwards. So look, if
this happens, you need to see a doctor straight away,
either at an urgent care clinic at your GP or

(03:37):
at a hospital. Will generally organize an X ray to
make sure there's no fracture or anything. Then you'll you'll
generally get some sedation so you relax, and then we'll
just give the shoulder of an attraction to try and
pop it back in. Now, generally, once that happens, you
need to be in the sling for one to two weeks.
And that's actually what happened with Chris Wokes when he
came out to do to bat at Number eleven. He

(04:01):
had his shoulder and a sling. So so that just
just stops it moving around. You're avoid listing from out
six weeks and it can take up to three to
four months to be fully fully back back back normally
using your shoulder, and you often need quite a bit
of physio to strengthen shoulder and make it work again.

Speaker 2 (04:16):
Okay, Yeah, it's tricky a and and you know, like
I say, you can sort of feel quite susceptible there
for ae while afterwards you can tear the cartilage and
all that kind of thing. But yeah, it looks really nasty,
so very much, best aboard and thank you so much, Brian.
Doctor Brian Betty is our doctor with us this morning.

Speaker 1 (04:34):
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