Joint Dislocations
Often portrayed as a high-risk injury in movies, joint dislocations occur more often than many may expect, acting as one of the most common injuries in athletics. Although they may look scary, they are often less serious, resolve quicker with treatment, and have a smoother recovery than many other prominent sports injuries.
What is it?
Dislocations are when bones in a joint, a place where two or more bones meet for movement, are separated or pushed into an abnormal position. Dislocations can occur throughout the body, though the most common dislocations occur around the fingers, shoulders, and knees. As a result, in rare cases, muscles, nerves, tendons, and blood vessels may be strained or torn, creating extreme pain and impairment. There are two different classifications, determined based on the degree of separation: luxations and subluxations. Complete dislocations, also known as luxations, are when bones are completely pushed out of place, whereas subluxations are when it is partially separated, with the bones still touching but out of place.
Causes:
Dislocations are a common injury, especially amongst contact athletics and trauma events, which generate enough force to push a joint out of place. These can be seen with falls, car accidents, and other sports injuries. Those older than 65, with health conditions that weaken connective tissues, or who experienced past dislocations are more susceptible to experiencing dislocations. It has been reported that dislocations occur most by those in their teens or twenties.
Symptoms:
Typically, those with dislocations will experience the following symptoms as a consequence of the forceful trauma placed on the joint.
Pain
Swelling - when there is an increased movement of fluid and white blood cells to the area
Bruising - when small blood vessels are broken and leak out
Tingling - the irritation or injury of the nerves
Temporary deformations - caused by the bones popping out of sockets, etc.
With movement, immobilization or immense pain may follow. Complications such as bone fractures, and muscle, ligament, or tendon sprains may arise due to the jerking movement, ultimately compromising the future stability of the joint.
Shoulder Dislocations:
Because the shoulder is the body's most flexible joint, the humerus is more likely to pop out of the socket, causing it to be more prone to dislocations. Injury may cause numbness or weakness near the area of injury, possibly resulting in pain in the neck or arm and shoulder spasms.
Kneecap Dislocations:
When the patella is dislocated, there will be an obvious deformation as the patella slides laterally out of the patellofemoral groove. Typically, the patella will dislocate laterally because of the natural structure of the knee. A medial patella dislocation is more of an indication of some sort of congenital issue. When the patella is dislocated, the knee will either be unstable and buckle when weight is put on it. It is important to try and reduce the dislocation (Pop it back into place) soon after with medical supervision to prevent further complications including ligament laxity from being placed in an extended position for an extensive period of time or difficulty popping it back into place. This is done by applying a gentle medial force on the patella while extending the leg. It is important to see a healthcare provider as soon as possible and it is likely that crutches or a brace will be recommended.
Finger Dislocations:
Most commonly occurring in the middle knuckle, a dislocated finger is usually obvious as the finger is bent at strange angles, appears pale, or occasionally breaks through the skin. It is important to be aware of any loss of sensation or color change which may indicate a lack of proper blood flow to the finger.
Diagnosis:
Usually, dislocations are obvious because of the gross deformity that accompanies the injury. However, subluxations are primarily diagnosed based on special tests and the athlete’s pain level. To diagnose any further complications, a healthcare provider will conduct a physical exam, utilizing the following imaging tests; x-rays, MRIs, CT Scans, and ultrasounds; to evaluate the severity. They will check for signs of nerve, blood vessel, muscle, and bone damage
Treatment:
Following a dislocation, the most important treatment is the relocation of the joint, which-- and this needs to be emphasized-- is only done by a healthcare provider. They may provide anesthesia or other medication to alleviate pain before the relocation. Depending on the severity and location, extended periods of rest, medication that reduces pain and inflammation, and wearing a splint or brace to inhibit movement may be implemented. Ice is another constant tool used throughout the healing process, aiding with mitigating inflammation. In severe cases, a dislocation surgery may be required in order to reset a joint or repair other damages within the body. If treatment is delayed, there is a greater risk of permanent disability and other complications.
Prevention:
Although dislocations are often caused by unpredictable behavior, prevention can include wearing appropriate protective equipment during contact sports, adequately warming up, cooling down, and stretching in order to ensure strength, mobility, and flexibility across joints. It is important to take action to reduce the risks of falls, whether by maintaining an uncluttered workspace or by utilizing canes or walkers for those more susceptible.
Sources:
Professional, Cleveland Clinic medical. “Dislocation.” Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/17873-dislocation. Accessed 26 Dec. 2023.
“Dislocated Shoulder - Symptoms and Causes.” Mayo Clinic, 23 Aug. 2022, https://www.mayoclinic.org/diseases-conditions/dislocated-shoulder/symptoms-causes/syc-20371715#:~:text=A%20dislocated%20shoulder%20is%20an,shoulder%2C%20seek%20prompt%20medical%20attention. Accessed 26 Dec. 2023.
“Dislocated Finger Basics.” WebMD, https://www.webmd.com/fitness-exercise/finger-dislocation. Accessed 26 Dec. 2023.
professional, Cleveland Clinic medical. “Patellar Dislocations.” Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/21633-patellar-dislocations. Accessed 27 Dec. 2023.