Episode Transcript
Interviewer: I'm sure all of us have seen a scene in a movie where the guy's shoulder gets put out of joint then either he or she or somebody does it for him, relocates it. Can you really do that in real life or is that a reason to go to the ER? We'll find out next on The Scope.
Announcer: This is "From the Front Lines," with emergency room physician, Dr. Troy Madsen, on The Scope.
Interviewer: So, if you've got a shoulder dislocation, is that something that, as the movies and TV shows sometimes indicate, you can take care of on your own? Or, is that something that you should go to the ER and have a doctor take care of? Dr. Troy Madsen is an Emergency Room Physician at University of Utah Health Care. Shoulder dislocation, what should I do?
Dr. Madsen: Shoulder dislocations, you know, it's one of these things where, technically, you probably could take care of it outside of the ER. I'm going to say that, though at the same time I'm going to tell you, you should probably go to the ER.
Interviewer: Let somebody that knows what they're doing move that around?
Dr. Madsen: Exactly, but . . .
Interviewer: They make it look so easy in the TV shows and movies.
Dr. Madsen: They do.
Interviewer: Is it that easy?
Dr. Madsen: It's not that easy, it's not that easy. And it doesn't involve this yanking on the shoulder and suddenly it pops in.
Interviewer: I've always saw it, I found a door frame and I put my shoulder up against it, and I just push into it, no?
Dr. Madsen: I don't know. There may be people who get chronic shoulder dislocations. It happens again and again, and maybe they've figured some way to do that. But the sooner you get to the shoulder dislocation, the sooner you're more likely to get it back in without any kind of medication or sedation.
Interviewer: Oh, so the longer you wait, the harder it's going to be to get it back into place.
Dr. Madsen: Yeah, so easily when I see someone in the ER, it's been out for several hours, their muscles have just tightened up, that shoulder's down there, they're feeling lots of pain. So, at that point I usually have to give them medication to sedate them or some sort of injection into the joint to numb it up. But technically, this is something that could be done before coming to the ER or if you were to treat someone quickly enough. Again, I'm not recommending you do this, but just for the sake of conversation I'm saying it is possible.
If you want to see some really cool, you google something called "The Cunningham Technique." That's for shoulder dislocations and there's this guy who developed the technique where essentially he sits straight across from the person who has shoulder dislocation, he has that person rest their hand from the affected shoulder on his shoulder, tries to get them to relax and then he gradually massages the biceps up to the deltoid, up to their upper shoulder, and that causes enough relaxation of that joint for that to pop right back in.
Interviewer: So, he's not using, like in the TV shows or the movies, force or jamming it back into place?
Dr. Madsen: No.
Interviewer: He's actually trying to relax things.
Dr. Madsen: That's the key. It's getting the person relaxed. And he's been very successful with this technique. We've used it in our Emergency Department several times on patients who have come in early after the shoulder dislocation. We haven't given them any medication. They haven't needed it.
It's just a matter of helping this person relax enough and relax those muscles. You tell them, "This is going to feel weird when it pops in, but it's not going to hurt." And it doesn't. Actually, it's pretty incredible.
Interviewer: So, you know, the medical profession says, "Do no harm."
Dr. Madsen: Yes.
Interviewer: Is this one of those things that, if somebody wanted to try it, it does no harm? I mean, we're back to your original statement. I'd like to say, "Yes, you could, but you probably should go to the ER."
Dr. Madsen: I'm going to stick with my original statement. Again, this is more for the sake of conversation.
Interviewer: All right, all right.
Dr. Madsen: But if you're in some kind of scenario where you're hours away from medical attention, just trying to get this person to relax, possibly massaging this area to get these muscles to relax, it might work.
Interviewer: All right.
Dr. Madsen: It's been proven, it's been shown many times. Realistically, if you're not a medical professional and this is something you don't have a lot of experience with, you probably need to go to ER. One challenge with shoulder dislocation is it's usually under a lot of force the shoulder comes out and there's always a possibility of something that's broken in there too.
Interviewer: Got you.
Dr. Madsen: Typically, we're going to get an X-ray first and then get that back in place.
Interviewer: And it's better to go sooner than later.
Dr. Madsen: It is. The sooner you go, the easier it will be to get it back in.
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