Joint Knowledge: Dislocations and Subluxations

Dislocations happen commonly in ball-and-socket joints.

These joints move freely in nearly any direction. The shoulder and hip are the primary ball-and-socket joints in the human body.

However, this freedom of movement also leaves them prone to dislocation and subluxation injuries. This happens when the “ball” slips out of place and loses its connection with the “socket.”

Dislocations can happen in other joints, too, when the bones fall out of alignment.

 

Symptoms of a Dislocated Joint

As you can imagine, dislocations are painful. Even a partial dislocation (a subluxation) can cause pain and difficulty moving the affected joint.

The most commonly dislocated joints are the shoulders and the fingers. Hips, knees, and elbows can also become dislocated but are less common.

Sometimes a dislocated joint is apparent. The bones are pushed out of alignment, and the joint looks visibly deformed. Occasionally, you may see a very violent play in a football game where one player leaves the field with a dislocation injury. While camera crews try to limit viewers’ exposure, they slip through now and then. And, yes, they hurt just as bad as they look!

Not every dislocation will have a gruesome appearance. This is especially true in the case of a subluxation. Partial dislocations or less severe injuries may only appear slightly out of place.

Regardless of appearance, a dislocated joint can be painful and difficult to move.¹ Depending on the severity, you may not be able to move the dislocated joint at all. Other symptoms include swelling and discoloration of the affected area.

Sometimes, a dislocation can cause damage to additional internal structures.¹ The tendons and ligaments that support the bones can be strained or torn. The joint may be more prone to arthritis. Muscles can likewise be torn or strained. The blood vessels and nerves surrounding the joint can be damaged. Serious complications require additional treatment.

 

Causes of Dislocation

As we’ve alluded to earlier, dislocations are always caused by severe trauma,² such as in contact sports. Repetitive motion, which is a risk factor for other injuries, does not contribute to dislocation injuries.

Football players are at especially high risk for a dislocation due to the nature of the sport. While not as common, basketball players are also at risk of dislocating finger joints, typically from improper contact with the ball.

Trauma from a car accident can also lead to a dislocation injury as can a hard fall. Previous dislocations can even put you at risk for future dislocations.² In addition, some people have looser ligaments. This can put them at higher risk for dislocating a joint as the bones aren’t held in place as firmly.¹

 

Treatment and Rehabilitation of Dislocations

Treatment of a dislocated joint always requires immediate medical attention.³ Do not wait to seek treatment if you suspect a dislocation.

Your doctor will examine the injury and determine the best course of action. For a minor dislocation, it may be possible to realign the bones with little difficulty.⁴ Even for a minor injury, however, you will likely need a local anesthetic to tolerate manipulation of a dislocated joint. Severe dislocations may require general anesthetic.

For some dislocation injuries, your doctor may need to perform surgery. This is especially true of more severe injuries, repeated injuries, and injuries with serious complications.

After your doctor resets the joint, you will need to rehabilitate it. A dislocation can take 6-12 weeks to heal fully.³ A severe dislocation or one requiring surgery may take longer.

While healing, you need to rest the injured area. You can follow a basic (P)RICE protocol to help ease pain, reduce inflammation, and help the damaged joint heal.

As the joint repairs itself, you can start gentle motions to rebuild your strength.⁵ During this time, you want to protect the injury, so movement should be mild. For more severe injuries, you may need physical therapy to heal properly.

 

Preventing Future Injuries

The best way to prevent a dislocation injury is to avoid impact sports and wear protective gear when you do play.

You also want to prevent any falls. If you are older and susceptible to falling, limit your alcohol consumption, and talk to your doctor about any medications you take.¹ Some prescription medications can make you dizzy, increasing the likelihood of a fall.

If you have a severe or repeat injury, you should work with a physical therapist.⁵ They can teach you exercises to increase your strength and stabilize the joint. This can help you avoid a recurrent injury.

References

1. Dislocation: Symptoms & Causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/dislocation/symptoms-causes/syc-20354113. Accessed 9/23/2020.
2. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/dislocations. Accessed 9/23/2020.
3. Medline Plus: Trusted Health Information for You. https://medlineplus.gov/ency/article/000014.htm. Accessed 9/23/2020.
4. Joint Dislocation and Displacement. Beaumont. https://www.beaumont.org/conditions/joint-dislocation-and-displacement. Accessed 9/23/2020.
5. Dislocation: Management and Treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/17873-dislocation/management-and-treatment. Accessed 9/23/2020.