By Carl Green 

 

In the last post we looked at strains and sprains. In this fourth post of my musculoskeletal conditions series we are going to be summarising the key information about dislocations. I was originally going to also cover cartilage tears, but realised I had too much to say and the post would be far too long, so I have decided to cover cartilage tears separately next time. 

 

To begin with, I would like to first state that dislocations are relatively rare, and bones do not tend to go out of joint or alignment, despite how this can be betrayed in the media, and unfortunately even by some health professionals. Generally our bodies are very resilient, especially our spines, with very strong ligaments that are designed to hold joints stable, and our bones in position. However, the joints affected when dislocations do occur include the shoulder (by far the most common), fingers, patella (knee cap), hip, elbow and ankle. 

 

In order to cover this topic in a clearer and more complete way I am going to divide dislocations into two main categories, traumatic (after a specific injury) and non-traumatic (when no injury has occurred). 

Firstly, I will discuss traumatic dislocations. This type of dislocation involves a significant external force pushing a joint out of position bringing the two bones associated out of alignment. Traumatic dislocations involve a significant external force pushing a joint out of position, bringing the two bones associated out of alignment, e.g. the majority of the joint surfaces, which are lined in cartilage, are no longer in contact. Due to the traumatic event causing significant stress to our bodily tissues, it is not uncommon to sustain other injuries at the same time, such as sprains and strains as mentioned in my previous post, but also cartilage tears, bony injuries (e.g broken bones), or damage to other soft tissues including blood vessels and nerves. 

 

Often due to the pain and an inability to move the joint affected, we would often take ourselves or have an ambulance take us to A&E for immediate assessment. It is really important to seek medical assessment and treatment when sustaining any significant traumatic injury. In regard to dislocations it is not wise to attempt to relocate the joint yourself, or with help from bystanders, as you may cause other injuries and would likely benefit from pain relief medication. 

 

After the joint has been relocated and you have been assessed for other potential injuries the main treatments in most cases will be short-term immobilisation followed by physiotherapy. The aim would be to gradually build strength and mobility for a few months while the affected connective and soft tissues have an opportunity to heal and re-establish their function. 

 

During and following initial treatment it may be that other areas of weakness, stiffness or laxity may be identified and these can then be addressed with us along the way. We may also identify potential risk factors that have made the injury more likely and can consider what we may be able to do to reduce your likelihood for injury in the future. 

 

 

Next I will discuss non-traumatic dislocations. As with traumatic dislocations the main issue is that the joint surfaces (articular cartilage) of two bones are no longer making contact, leading to an inability to move that joint effectively. However, this time we have the less common scenario where a dislocation has occurred, despite there being no significant injury or event. 

 

Non-traumatic dislocations are usually associated with connective tissue conditions such as significant hypermobility or developmental differences in the shape of bony/joint surfaces, leading to increased freedom/looseness (laxity) of the joints involved. These types of dislocations do not tend to be quite as painful or cause damage to other tissues like I have described for traumatic dislocations. However, they should still be immediately assessed by a medical professional if they do not relocate themselves within minutes. 

 

Sometimes the joint is not fully out of joint and we call this subluxation which often resolves on its own without any input needed. Non-traumatic dislocations can also often relocate on their own through offering support to the area affected and gentle attempts to move the joint. In these situations it would be advised to contact your GP or private health provider to consider if any additional assessment or treatment would be useful. 

 

In this scenario physiotherapy is likely to be one of your key treatment options and involves improving your coordination, strength, and learning how to best manage the additional freedom of movement that you may have in the affected areas. It is also likely that you will need to continue these practices on your own (after being provided guidance), or with intermittent support from us, in order to keep on top of it and reduce the likelihood of having repeated dislocations.  

 

Often people with these types of conditions (hypermobility etc) feel as if their body is tight and that it needs stretching or manipulation. However, in fact this is almost the opposite of what is often needed, as you already have lots of freedom of movement, so what you are more likely to need is more control, stability, and strength to prevent excessive movement where irritation or problems may occur. 

 

If you have suffered a non-traumatic dislocation then book an appointment with Colchester Physiotherapy Clinic today to begin your treatment.activities. 

 

 

I hope you’ve found this post useful or interesting. Please take a look back at my previous posts in this musculoskeletal condition series as they may also be helpful. 

 

As always, if you like help with these types of conditions then myself (Carl Green), and my physiotherapist colleagues Craig Fowlie and Jane Marr at Colchester Physio and Sports Injuries Clinic, are highly qualified and experienced clinicians that would love to support you. 

 

My next post in this “musculoskeletal conditions” series will discuss cartilage tears, again using a similar format covering those that are traumatic, and those that are not. So please check back in or follow us on social media to see when it is published. 

 

If you are having issues with any of the different types of musculoskeletal conditions we would advise you to speak to a professional. Our team are experts in treatment and rehabilitation of musculoskeletal injuries or problems, and can offer you practical and effective advice on how to avoid or deal with a wide range of musculoskeletal conditions. If you require any more information about our services, reach out today or give us a call on 01206 579631.