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An experienced physician who suspects an athlete has a dislocated shoulder will usually be able to make a diagnosis based on the mechanism of injury and physical examination. The first step in the treatment of an athlete with a dislocated shoulder is to replace (reduce) the humerus back into the glenoid socket. This reduction as it is called can usually be accomplished with gentle traction of the arm while pressure is applied to the dislocated joint. Once the joint is reduced, the player’s arm is placed in a sling for comfort and support. There is some controversy as to the optimal definitive treatment for the player who has his first dislocation. Most experts now recommend conservative (non-operative) treatment for the initial episode. Physical therapy consisting of a range of motion exercises and progressive strengthening activities is always prescribed. This allows the athlete to return to play within 4-6 weeks. A brace may be used that can be worn under the shoulder pads to aid in preventing a recurrence. Unfortunately, these braces restrict the player’s motion and, therefore, cannot be used by those players whose position necessitates overhead motion (i.e. wide receiver).
Surgery is recommended for a person who experiences multiple dislocations or who chooses to undergo surgical stabilization following the first episode. Historically, surgical repair was done through an open incision. Now, this procedure is most commonly performed arthroscopically. The labrum that is torn is repaired back to the bone socket using a variety of either metal or plastic anchors in order to re-establish the stability of the joint. Following surgery, the athlete is kept in a sling for four to six weeks. Physical therapy is prescribed to regain shoulder motion, strength, and return to football-related activities.