Ouch. Author researching the pay method of shoulder relocation.
As anyone who has had the wonderful experience of having his or her shoulder out-of-socket knows, once initially dislocated, your shoulder’s nasty habit of jumping ship will increase. Shoulder dislocation sucks at base—add a backcountry environment, minimal funds, being alone, or just being far away from medical help to the mix, and the need for a DIY solution becomes evident.
The real kicker is that as the potential of dislocation re-occurrence is almost guaranteed, so is your potential for increased visits to the over-priced cold table and an increased ‘injury’ budget—and that really, really sucks. Fortunately, here at the Backcountry.com offices, we’ve had vast cumulative ‘experience’ in this specific field, and we’d like to pass the savings on to you—I’m talking about putting your own shoulder back into place, of course.
This guide is not meant to be a substitute for professional medical help. Always seek medical attention in the event of a shoulder dislocation … that will be all …
Something’s not right with this picture.
Though you should always seek medical help in the event of joint dislocation, there are instances in which the knowledge of how to ameliorate the problem on your own can be invaluable. One nice thing about the heightened chance for dislocation after an initial dislocation injury is that one’s shoulder becomes easier—and markedly less painful to re-locate. This should be great news for all the DIY-ers out there. Another important fact to note is that the sooner you’re able to re-locate your arm, the less soft-tissue trauma, lasting pain, and recovery time you’ll incur. More often than not, an arm is at least usable immediately after relocation—this is huge when you’re relying on yourself and only yourself to get you out of the backcountry.
Beyond the basic inability to use an expatriated limb and the initial and obvious pain that results in your shoulder being in the completely wrong place, shoulder dislocation often causes pressure on the brachial artery, which will cause your entire arm to ‘fall asleep’ after a while. Take that thought into consideration in the context of a cold or stormy environment, and you add cold issues/frostbite issues to your already dislocated, numb arm.
So—on to the point: how do we make the hurt go away?
Tried and True Methods:
Lace the fingers:
During my second trip to the hospital for an errant limb, the doc informed me that the laced-finger method of shoulder relocation is one of the greatest hits among the shoulder relocation DIY crowd.
Here’s how it’s done:
- Sit down
- Interlock or ‘lace’ your fingers together.
- Put your laced hands over your kneecap (use the knee that corresponds with the dislocated limb; i.e., if your left shoulder is dislocated then lace your fingers over your left knee),
- Slowly sit back/pull back on your dislocated joint until it slips (yeah that word makes me cringe too … it hurts just as bad going in as it did coming out) back into place.
This method rules because you don’t need any one, or anything, else to put your shoulder back into place. Unfortunately, this method doesn’t always work, so if the laced-finger method ain’t poppin’ so-to-speak, you might want to move on to something just as painful.
90-Degree-Elbow Arm Fly:
Cool name, eh? Here’s how it’s done:
- Hold your dislocated arm parallel against your body
- Bend your elbow 90 degrees so your hand is sticking straight out in front of you
- SLOWLY rotate your arm (from your shoulder) around your body, keeping your bicep and upper arm pressed against your body—rotate your hand so that it goes from pointing straight out in front of you to pointing straight out to the side of you.
- As you rotate your shoulder, your joint will take up its natural motion—sucking your arm back up into socket. Mmmmm, hurts so good.
If your empty-handed attempts prove unsuccessful, try holding something in your hand (ski pole, water bottle, etc.) to give your arm more weight for your empty joint to react to—this will help your arm find its home more easily.
Gravity Rides Everything:
Gravity is amazing. Scientists aren’t sure where it comes from or how or why it works, exactly, but I can tell you that this shining star of the Four Fundamental Interactions can fix your immediate dislocation problem.
Here’s how:
- Lie on your chest in a location that allows your arm to hang down freely at a 90-degree angle from that of your lying body
- As it swings down it will slip back into place
This one will be difficult if done solo over a low-hanging branch or a stump, as it will hurt like a mother when your arm tries to follow gravity back home to its socket (this is due to the fact that a dislocated arm likes to lay parallel against the body, limply and grotesquely, and when you initially coax it back into returning home, your joint will undoubtedly voice its unhappiness). This becomes much easier if you have a friend to support your arm as it slowly swings down perpendicular to your body and back up into your socket (slip!).
If your attempts at this method are unsuccessful, it may be because your arm’s own weight (thanks for nothing, Gravity) isn’t sufficient to put your shoulder back into place. Try holding a weighty object as you or your friend lowers your arm to a perpendicular position. Anything from a full water bottle to a loaded backpack will suffice.
Once you re-attain civilization, it’s always a good idea to increase your intake of Vitamin I—800mg’s of Ibuprofen is the doc’s most-prescribed post-trauma candy. Make sure you follow any dislocation with a healthy regimen of OTC pain-relievers and anti-inflammatories (Vitamin I covers both those bases). Icing your joint will do wonders for your recovery time as well, so keep that joint nicely chilled for at least a few days after your injury.
Got any epic DIY injury-repair stories or better methods of re-locating a shoulder? We wanna hear ‘em.
Post your injury stories and tips in the comment section.
Last year I had to displeasure of popping my shoulder out while heading down a couloir. Everything was going great, then I hit some unexpected crust which through me head over heels. While cartwheeling I felt it pop. Ugh. I was in a place where avi danger was high, and I had to get outta there fast, so without much thinking I just punched forward/down with my arm and the shoulder poped back in.
Granted, this all happened very fast, and I barely thought/contemplated anything, just BAM, then skied to safety. This was day 1 of a 7 day trip. Advil was my friend.
Thanks for the other tips though, as I’m guessing this might happen again where I might not be as fortunate.
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never done a shoulder but have set MANY of my own bones and even sewed myself up, if y’all want some good gore stories, i have TONS! thanks for the info, i LOVE you Backcountry folk!!
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My shoulder has been out more times than I can remember and I’ve never been able to get it back in by myself. The first time I dislocated it, I had to be put under at the ER to get it back in. The best method I’ve found requires 2 additional people and works as follows:
1. Lay down on your side with your non-dislocated shoulder resting against the ground
2. Wrap a shirt or something similar under the dislocated shoulder
3. Have one person pull in the direction of your head with the shirt and the other on your arm towards your feet. It’s important that your arm is kept parallel to your body when pulling in both directions. From my experience, it takes a considerable amount of force to pull your shoulder back in.
This is the only method I’ve had work every single time. I would highly advise against hitting your shoulder against something (aka “lethal weaponing it”) to pop it back in. There is a high risk of damaging/fracturing if you do this. On that note….it’s been close to 3.5 years since I last dislocated my shoulder skiing. I credit that mainly to strength training and doing specific exercises that increase shoulder stability.
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Never done a shoulder. But I have done ankles. I dislocated my ankle bouldering one day, and accidentally discovered a great way to relocate it. All I had to do was try pulling my climbing shoes off. Slipped my ankle right back into place. And only startled me a little (a lot).
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I’ve used the 90-Degree-Elbow Arm Fly aka. Baseball Arm on myself before, but it is difficult because the same muscles that support the weight of the arm can impede reduction.
My newer technique comes from the kayaking community, and it’s for solo relocation.
1. Find a comfortable seated position.
2. As slowly as possible, starting at your sternum, walk the fingers of the injured arm up the center-line of your chest.
3. Continue over your nose, and somewhere between your forehead and the crown of your head, you shoulder should find its way back home.
After surgery, I’ve found that maintaining overall shoulder and back strength and flexibility is the best way to prevent further shoulder instability.
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Disclaimer: it’s my job to fix these. I’m a knee & shoulder surgeon.
Kudos to BC for getting this information out there. What you call the ‘lace the fingers’ and the gravity are the ones I teach for wilderness medicine solo relocations. If you have a buddy, an ER doc in Breck told me he gets most in by supporting the elbow and simply trying to take the hand up to where the palm is behind the head ‘lounge position.’ He rarely needs to use medicine b/c he uses calming thoughts and breathing techniques (‘verbal anesthesia’) which will probably be about all you have available.
This info would have saved an old HS buddy of mine a heli rescue off Ranier a couple years ago. It was funny because he had two docs on the trip (pediatrics & cardiology) and neither of them knew what to do either. Now some Backcountry.com big pow shredder can tell the cardiologist to “step aside” and handle the situation!
Final thought: each time your shoulder comes out of socket, there is significant damage done to the surface cartilage and surrounding soft tissues. If it becomes easier to get it back in, that’s actually a bad sign. I know there are time and money considerations, but success rates for arthroscopic repair are very high. I’ve seen too many guys who have been dislocating for years and have done irreversible damage and now can’t climb or even shoot baskets in their early 30s. Sorry to be the wet blanket.
Go get some of this amazing April pow!
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Oh, what a painful post. I relocated my shoulder after a skiing accident when I accidentally adjusted myself in my car to drive home/hospital. Had my arm down my side arm bent. I pressed on the arm rest to adjusted where i was sitting slighty and it popped right back in. Was on the blue tooth with my gf at the time who was many states away. I think she might have heard me yell both through the phone and through the air. Ended up having a broken shoulder as well as the dislocation, not fun especially right before my ski trip to Austria.
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[...] dislocate your shoulder miles from the nearest ER: “Another important fact to note is that the sooner you’re able to re-locate your arm, the less soft-tissue trauma, lasting pain, and recov…. More often than not, an arm is at least usable immediately after relocation—this is huge when [...]
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