Getting to a doctor (or an appropriately trained medical professional) quickly is important when dealing with a dislocated shoulder because when the muscles, tendons and ligaments around the injury tighten up, the head of the humerus becomes very difficult to relocate without surgical intervention. Most doctors will likely want to x-ray your shoulder area before doing anything else in order to rule out a fracture.  If nothing is broken or badly torn, then the doctor can perform a closed reduction maneuver on the shoulder joint, although you may need a sedative, strong muscle relaxant or general anesthetic before the physical manipulation can be done due to the severe pain. A common reduction method for the shoulder joint is called the Hennepin maneuver, which utilizes external rotation of the shoulder. While laying flat, the doctor will flex your elbow to 90 degrees and gradually rotate your shoulder outward (external rotation). Some gentle pushing while in this position is usually enough for the joint to relocate. There are a handful of other reduction techniques that doctors use — it depends on what they feel comfortable with. If your shoulder is regularly dislocating (due to a bone deformity or ligament laxity), or if any bones are fractured or nerves and/or blood vessels ripped, then you'll need surgery to repair the damage and have the shoulder joint reduced openly. Surgery is sometimes the best option because it can fix internal damage and stabilize the joint, which greatly reduces the risk of dislocation in the future.  There are many different surgical procedures that are performed, so it depends on the extent of the damage and the patient's lifestyle/activity level as to which technique is used. Some studies suggest that surgical "open" reduction may be the best course of action for active adults younger than 30 years due to lower recurrence rates and better quality of life outcomes. Regardless if you get a closed manual reduction or an open surgical reduction, you should get a referral for physiotherapy and strengthen your shoulder joint. Physical therapists, chiropractors and/or athletic therapists can show you specific stretches to regain full mobility and range of motion in your shoulder, as well as exercises that strengthen and tighten the joint so that it's unlikely to dislocate in the future.  It often takes two to four weeks of recovery before a referral to physical therapy is appropriate. Wearing a sling, applying ice and taking over-the-counter medications is all part of the recovery phase.  The total time to rehabilitate and recover from a shoulder dislocation ranges from three to six months, depending on the severity of injury and if the patient is an athlete or not.
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