Having played a lot of Rugby since a young age, it has
become a central part of my life outside of, as well as within school. Having played
a couple of times for the 1st XV while in year 11 I was excited
about the next season when I would be a part of the sixth form. However,
towards the latter half of my U16 season I badly dislocated my right shoulder
while making a tackle. The injury was one of the most frustrating things I have
had to deal with, keeping me off of the pitch for the rest of the season! After
much physiotherapy and recuperation I was very much looking forward to what the
forthcoming season held. However, after a promising start to the season for the
team unfortunately the injury reoccurred in a similar fashion but to an even
worse extent. Although on the first incident the shoulder had to be put in
place by the A&E team, it had only been displaced for an hour or so. This
time perhaps due to the reoccurring stress on the shoulder, the A&E team
were not quite so successful taking along the lines of 8 hours before I finally
felt the pop I had been dreading. Because of my personal involvement with this
injury, it has become something that I have endeavoured to find out more about
and so in this article I will try to briefly explain the injury as well as the
rehabilitation process I am currently undergoing.
A shoulder dislocation occurs when the shoulder is
wrenched upward and backward for example, while under great pressure from an
external force. The force can be such as a fall or collision (as I experienced)
with enough strength to displace the shoulder. The anatomy of the shoulder
means that approximately 95% of shoulder dislocations occur at the lower front
of the joint. There are two main parts to the shoulder; the socket of the scapula
(the shoulder blade) and the humerus (the ball attached to the arm). Because of
the shallowness of the socket, it makes the shoulder particularly vulnerable.
For this reason the scapula is “extended” by an area of cartilage and is supported
by ligaments called the joint capsule. Furthermore a group of four tendons
collectively called the rotator cuff, reinforcing the shoulder joint from above
in front and behind. When the arm is
moved away from the body and rotated in a certain position, the joint gives way
and the humeral head is ripped away from the scapula socket. The stress on
other features of the shoulder, such as ligaments in the rotator cuff, the ring
of supportive cartilage and the joint capsule are torn.
Upon getting to A&E I was given medication to
reduce the pain such as codeine. I was also greatly thankful for the Nitrus
Oxide which was the only thing that seemed to moderately reduce the pain before
morphine was administered! The dislocation is then confirmed on X-Ray in order
to make sure the diagnosis is correct, while also checking for any other breaks
in the neighbouring bones. The shoulder is then moved into a number of
different positions, while being put under different pressures in order to
relocate it. This is not a pleasant experience!
The shoulder is then usually placed in a sling which
immobilizes the joint and greatly reduces the amount of movement experienced by
the entire shoulder. This helps to reduce the risk of recurrent dislocations.
After a number of weeks, the range of motion is then gradually increased, with
strength exercises added in order to return the joint to normal function. Recurrent
dislocations are common due to the damage done to the tendons and ligaments
after the initial dislocation. Having suffered from two dislocations in recent
past I am now awaiting shoulder surgery which will help to repair damage to the
scapula joint and restore normal function.
It’s not all bad however. The injury has left me with
a desire to perhaps pursue a career in orthopaedics somewhere in the future!
Sam
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