A shoulder dislocation is when the rounded head of the upper arm bone comes out of the shoulder socket, and in most cases the shoulder comes out towards the front [1][2]. A doctor puts the shoulder back in hospital under pain relief or sedation, followed by a short time in a sling and physiotherapy; recovery usually takes 6 to 12 weeks [1][2][4]. The risk of it coming out again is highest in young men who play contact sports, and surgery can be discussed after a first dislocation in this group [1][4][5].
What happens in a dislocation?
The shoulder is a ball-and-socket joint: the rounded head of the upper arm bone (humerus) sits in a shallow socket in the shoulder blade. The ring of cartilage around the socket rim (the labrum), the ligaments and the rotator cuff muscles hold the joint in place [2].
In a dislocation the head of the bone separates fully from the socket, most often towards the front (anterior dislocation). Sometimes the bone comes only partly out and may slip back by itself [2].
How do you recognise it?
A dislocation usually announces itself with sudden, severe pain [1][2]:
- Being unable to move the arm
- A visible change in shape, with the normal roundness of the shoulder lost
- Severe pain, swelling and bruising
- Numbness or weakness in the arm
Why does it happen, and can it come out again?
A dislocation usually follows a forceful blow: a fall or collision in sport, a fall from height and road accidents are the commonest causes. Seizures and electric shock can also make the shoulder come out [2].
In the first dislocation the labrum on the rim of the socket can tear (a Bankart lesion); this tear and stretched ligaments can set the stage for the shoulder coming out again later [3]. The risk of recurrence is closely tied to age and is highest in young men who play contact or overhead sports [1][4].
How is it diagnosed?
Before the shoulder is put back, the doctor checks nerve and circulation in the arm and repeats the check afterwards [4].
X-rays from two different angles confirm the dislocation and show any accompanying fracture, and are repeated after the shoulder is back in place [2][4]. MRI or CT may be requested later for ligament and cartilage damage. Between ages 40 and 60 a rotator cuff tear is more likely to accompany a dislocation, so an ultrasound or MRI assessment is advised [2][4].
First aid and putting the shoulder back
Neither you nor bystanders should try to put a dislocated shoulder back; this should be done in hospital by a doctor. On the way to hospital the arm is supported without moving it and a cold pack can be used [1].
In hospital the shoulder is guided back into its socket under pain relief or sedation (closed reduction), which often eases the pain markedly straight away [1][2].
Sling and physiotherapy
Afterwards the arm is supported in a sling. Keeping the arm still for a long time has not been shown to lower the risk of it coming out again, so early movement, as pain allows, is advised [4].
Physiotherapy starts with gentle movement exercises and moves on to strengthening the muscles around the shoulder, usually continuing for a few weeks up to three months [2][4].
When is surgery discussed?
Surgery may be suggested for repeated dislocations or when there is ligament or bone damage: loose ligaments are tightened, the torn labrum is stitched back to the socket and any bone loss is addressed [2][3]. It is mostly done arthroscopically (keyhole); open surgery may be needed in complex cases [3].
After a first dislocation, surgery can be discussed especially for young, active patients who play contact sports [2][4]. In a meta-analysis of randomised trials, about 6% of patients operated on after a first dislocation had it come out again, compared with about 47% of those treated with a sling alone [5]. The decision is shared and rests on age, sporting and work expectations and the examination and imaging findings.
How long does recovery take?
Recovery usually takes 6 to 12 weeks; return to sport can take longer, 16 weeks or more [1]. Keeping the muscles around the shoulder strong helps prevent it from becoming loose and coming out again; the physiotherapist and doctor decide together when you return to daily tasks and sport [1][2].
When not to wait
Go to the emergency department straight away; do not drive yourself and call emergency services if needed (112 in Northern Cyprus and Türkiye) [1]:
Frequently asked questions
- Can a dislocated shoulder go back in by itself?
- Partial dislocations can sometimes slip back by themselves [2]. Still, do not try to put the shoulder back yourself; this should be done by a doctor in hospital [1].
- How long do I wear a sling?
- For a short time. Keeping the arm still for longer than a week has not been shown to lower the risk of re-dislocation, and early movement as pain allows is advised [4].
- How long does a dislocated shoulder take to heal?
- Usually 6 to 12 weeks; return to sport can take 16 weeks or more [1].
- Should I have surgery after a first dislocation?
- In young, active patients who play contact sports the risk of it coming out again is high, and surgery after a first dislocation markedly lowered that risk (about 6% versus 47%). Other patients usually start with physiotherapy; the decision is made with your doctor [4][5].
At our clinic, once the shoulder is back in place, we look at your age, sport and imaging findings and decide with you whether to start with physiotherapy or to discuss surgery.
Sources
- Dislocated shoulder. NHS (nhs.uk), 2026. nhs.uk
- Shoulder Dislocation. American Academy of Orthopaedic Surgeons (OrthoInfo). orthoinfo.org
- Chronic Shoulder Instability. American Academy of Orthopaedic Surgeons (OrthoInfo). orthoinfo.org
- BESS/BOA Patient Care Pathways: Traumatic anterior shoulder instability (Brownson P, et al.). British Elbow & Shoulder Society / British Orthopaedic Association, Shoulder & Elbow, 2015. journals.sagepub.com
- Shoulder Stabilization Versus Immobilization for First-Time Anterior Shoulder Dislocation: A Systematic Review and Meta-analysis of Level 1 Randomized Controlled Trials (Belk JW, et al.). The American Journal of Sports Medicine, 2022. pubmed.ncbi.nlm.nih.gov
This article is general information and does not replace an examination or imaging. If you have symptoms, see a doctor.
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