Whether your shoulder dislocates again depends mostly on your AGE at the first dislocation.
- Teens and early twenties: about 7 in 10 will dislocate again
- Mid-twenties: about half
- 30s: about 1 in 4
- Over 40: much lower, but a different problem takes over. See dislocated shoulder over 40
Men are more likely to dislocate again than women. Most repeat dislocations happen within the first two years, but they can happen later.
Why young shoulders come out again
- In young people, the ball usually tears the rim of cartilage (the labrum) off the front of the socket on the way out. That rim is part of what holds the ball in
- It often doesn’t heal back in the right place, so the shoulder is left looser than before
- Young people also go back to the sports that caused it: contact sport, throwing, climbing
Your age at the first dislocation predicts the second one better than anything you do in the sling.
What doesn’t change the odds
- How long you wear the sling. Wearing it longer than about a week hasn’t been shown to reduce repeat dislocations. The sling is for comfort. See how long to wear a sling
- Special braces that hold the arm turned outward. The results are mixed, and the major guidelines don’t recommend them routinely
- Exercises alone. Strengthening improves pain, strength and function. It hasn’t been proven to stop the shoulder coming out again
What does
- Surgery to repair the torn rim, in young, active people. It cuts repeat dislocations sharply. See surgery after a first dislocation
- Waiting before going back to sport. The earlier you return, especially to contact sport, the higher the chance it happens again
Some good news, and some less good
- Shoulders often settle down over time. In a 25-year study, many shoulders that kept dislocating in the early years stopped doing so later
- Arthritis can follow anyway. Some shoulders develop wear years later, even ones that never dislocated a second time. The first dislocation does some of that damage on its own
The dislocation that gets missed
- Most dislocations go out the FRONT. A small number go out the back
- Back dislocations happen after seizures, electric shocks or a heavy blow to the front of the shoulder
- About half are missed on standard X-rays
- The giveaway: the arm is held turned inward and you can’t turn it outward at all. If that’s you after a seizure or unexplained collapse, ask for an “axillary view” X-ray by name
Go to the emergency department now if
- The shoulder is still out. Don’t wait, and don’t try to put it back yourself
- The hand is cold, pale or numb
- You can’t tighten the muscle on the outside of the shoulder
- The arm is stuck overhead and won’t come down
Get it checked if
- You’re over 40 and the arm is weak after it was put back
- You can’t turn the arm outward after a seizure or collapse
- The shoulder feels loose, slips or “goes dead” with overhead movements
- You’re young, active and want to know whether surgery makes sense
Young and active: think about the second dislocation now. Over 40: think about your rotator cuff.