Shoulder dislocation is a painful injury that occurs when the upper (ball-like) end of the humerus comes out of its natural location, the concave joint of the shoulder girdle. Once the dislocation is reduced, the shoulder can be immobilized with a bandage (or kinesiology tape) to reduce pain, provide support to the joint, and help stretched tendons and ligaments heal quickly. Furthermore, the same bandaging technique that is used to treat dislocations can also be used to prevent them; this is why some athletes use sports tape as a safety measure.
Steps
Part 1 of 2: Preparing to Band the Dislocated Shoulder
Step 1. If you suspect your shoulder is dislocated, go to the emergency room
This injury is common when playing sports or when falling on an outstretched arm. The signs and symptoms are: intense pain in the joint, inability to move the shoulder, immediate edema and / or hematoma, and obvious deformity of the area (for example, the shoulder "hangs" lower than the other). If you are concerned that you may have suffered this injury after physical trauma, go to the emergency room or a health facility immediately.
- The doctor will take x-rays to confirm the dislocation and make sure there are no bone fractures.
- They may also recommend or prescribe medications to help control the intense pain that accompanies shoulder dislocation.
- Remember that dislocation is a very different trauma from shoulder separation. The latter involves the ligament of the joint that connects the clavicle to the anterior part of the shoulder girdle; in this case, there is no alteration of the anatomical continuity between the head of the humerus and the scapula.
Step 2. Undergo a reduction of the dislocation
Before evaluating the bandage or immobilization, the head of the humerus must be repositioned in its place, in order to restore the scapulohumeral joint. This procedure is called closed reduction of the dislocation; it is performed by a doctor who applies some traction and rotation to the arm to guide the bone until it is properly aligned with the shoulder. Depending on the intensity of the pain, administration of a local anesthetic (by injection) or oral analgesics may be necessary.
- Never let an unauthorized person (such as a friend, family member, or passerby) try to reduce your shoulder dislocation, as it could cause more harm than good.
- When the shoulder is repositioned, the pain level should decrease rapidly and significantly.
- Apply ice immediately after reduction for at least 20 minutes; by doing so, you keep inflammation and pain under control. Remember, however, to always wrap the ice pack in a thin sheet or plastic bag before placing it on your skin.
- It is always a bad idea to block or bandage a shoulder without first reducing the dislocation and is never advised.
Step 3. Prepare the shoulder by cleaning and shaving it
Once the joint's anatomical normalcy has been restored, the pain has reduced and is under control, you need to prepare the shoulder to be immobilized. To allow the kinesiology bandage or adhesive tape to adhere perfectly, the skin must be clean and shaved. To do this, wash your shoulder with soap and water; afterwards, spread some shaving cream and carefully remove all hairs (if possible) with a safety razor.
- After you have finished shaving, dry your skin thoroughly and wait a couple of hours for the mild irritation to disappear. At this point, you may want to consider applying spray adhesive before the bandage to allow the tape or bandage to adhere better.
- Not only does the hair prevent the kinesiology tape from sticking to the skin, it also causes a lot of pain when removing the bandage.
- Depending on the amount of hair, you will need to shave the shoulder area, shoulder blade, chest area and also the base of the neck.
Step 4. Gather the necessary materials
Get all the essential elements to perform an immobilizing shoulder bandage; it is material available in pharmacies or in orthopedic shops. In addition to the spray adhesive, you will need some orthopedic foam or skin protector (to protect the sensitive skin of the nipples), some rigid medical adhesive tape (preferably 38 mm wide) and an elastic bandage (75 mm wide is the best). Remember that you will need outside help, even if you are very experienced with this procedure.
- If you are in the office of an orthopedist, physiotherapist, athletic trainer, or sports doctor, there will likely be all the products you need for the bandage. The family doctor, his assistant, chiropractor, and nurses may not have all the material, so it's worth taking it with you.
- However, if you went to the emergency room (as you should have) to get proper care and undergo a reduction in dislocation, your healthcare professional will likely apply the bandage as well. Eventually, you will likely be given a shoulder strap to wear.
- The shoulder immobilization technique after dislocation reduction is certainly helpful and prevents further injury. However, it is not considered a medical necessity and, if there are many patients in the emergency room, this procedure is likely to be postponed until the next day during the scheduled follow-up visit at the orthopedist.
Part 2 of 2: Shoulder Bandage after Reduction
Step 1. Apply orthopedic foam or skin protector
After cleaning, shaving, and spraying your skin with liquid adhesive, apply a thin layer of skin protection to sensitive areas, such as nipples, pimples, healing wounds and blisters. This way, you will avoid pain and irritation when the adhesive bandage is removed later.
- To save time and material, cut small pieces of skin protector and place them directly on the nipples and other delicate areas. The foam will adhere to the spray adhesive for at least some time.
- Remember that although the shoulder bandage is worn over the shirt and underwear, the adhesive bandage is applied directly to bare skin and under all other clothing.
Step 2. Apply the anchor strips
Start by placing these segments of duct tape on your shoulder and biceps, at the front of your arm. Adhere a strip of kinesiology tape to the base of the nipple and stretch it upward, over the shoulder to the midpoint of the shoulder blade. Add one or more strips on top of the first one for extra support. Next, wrap 2-3 segments of bandage around the midline of the bicep.
- At the end of this stage of the process, you should have an anchor segment extending from the nipple to the upper back and another strip or bandage around the bicep.
- Don't over tighten this second anchor, or you may cut off the blood circulation in your arm. If you experience tingling or numbness in your hand, your blood supply is insufficient.
Step 3. Make an "X" bandage over the shoulder, using kinesiology tape
Support and protect the joint by applying 2-4 segments of bandage diagonally and in opposite directions from one anchor point to another. In this way, an "X" or cross should form around the shoulder, with the intersection point centered just above the deltoid muscle (the lateral shoulder muscle). At a minimum you should use two strips, although it is better to use four to ensure greater stability.
- The tape must be well adherent without creating discomfort; if you feel pain from the bandage, remove it and start over.
- Although it is always a good idea to use breathable adhesive tape to bandage the injured areas, in the case of a dislocated shoulder the thicker and more resistant one is preferred, because it allows a more effective bandage.
Step 4. Perform a "corkscrew" bandage from the chest to the biceps
Start at the outer edge of the nipple and slide a strip of tape over the shoulder and then wrap it around the arm muscle. Basically, you're joining the two anchor points one more time, but this time from the front, rather than the side (as described in the previous step). When the strip passes under and around the arm 2-3 times, a spiral pattern is created.
- When bundling your arm, you should use 2-3 separate strips, so that the "corkscrew" bandage is not too tight and does not interrupt blood circulation.
- Once this step is complete, re-secure the bandage with an additional strip over each original anchor. Generally speaking, the more tape that is applied, the tighter the bandage.
- Remember that this type of taping is also done to protect the shoulder from trauma or to prevent it from getting worse, especially when playing contact sports, such as rugby or football.
Step 5. Secure and cover the adhesive bandage with an elastic bandage
Once you have applied the strips of kinesiology tape on the shoulder, you need to switch to the elastic bandage. Wrap the bandage around your chest, over the injured shoulder, and under the bicep. Run it around the back to the opposite armpit (that of the sound arm) and back over the chest to the armpit of the dislocated shoulder. If the bandage is long enough, repeat this movement a second time for more support and finally secure the end with metal clips or a safety pin.
- The adhesive bandage is covered with the elastic band mainly to prevent it from coming off and to provide a little more support.
- When you have to apply cold therapy, it is much easier and faster to take off the elastic bandage, put the ice pack (on top of the kinesiology tape) and then block everything with the elastic bandage.
- To recap: you have to apply two anchor points, connect them laterally with an "X" bandage and internally with a "corkscrew" bandage; the whole is then wrapped in an elastic bandage that extends over the chest and back.
Advice
- Although each person has different recovery times, shoulder dislocation typically heals in 1-3 months.
- You can potentially speed up the recovery process if you immobilize your shoulder with tape immediately after the dislocation is reduced.
- Once the joint has been repositioned in its natural location and bandaged with kinesiology tape, you can use a shoulder strap to reduce the effect of gravity (traction).
- Consider removing the bandage and reapplying it after a week or so if you are recovering from an injury.
- Physiotherapy may be required to restore mobility to the injured shoulder. After 2-3 weeks from the bandage, the orthopedist may advise you to see a physiotherapist, to improve the strength and stability of the joint; in addition, you will need to do some stretching exercises.
