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In our physical therapy program, we are required to do a research project. I have chosen to do mine on helping reduce the number of shoulder dislocations in our local community. This is a problem that has been identified by the emergency room physicians. They say it seems to be on the rise. Right now, I'm just collecting as much information as I can find and see where it leads me. Can you tell me if this is a national problem?

According to the Consumer Product Safety Commission (CPSC) the number of reported cases of shoulder dislocation has more than doubled in the last 20 years. They base their statistics on a National Electronic Injury Surveillance System (NEISS). The information is collected from the emergency departments of 100 hospitals across the United States. The hospitals selected are supposed to represent a broad range of hospitals from small to large, rural to urban, and include children as well as adults. Over a four-year period (from 2002-2006), there were almost 9,000 cases of traumatic shoulder dislocations reported. This doesn't include the number that occurred without trauma. The total number of shoulder dislocations reported is probably under estimated for several reasons. Many people manage to put the shoulder joint back in place and don't report it at all. Others see their primary care physician or go to an orthopedic surgeon (perhaps someone who has treated them in the past for other things or even for a previous shoulder dislocation). Cases like that don't get reported through the hospital emergency department database. In the CPSC-NEISS report, major risk factors for shoulder dislocations included age (young and old), sex (males), and activity (sports or recreation). Football and basketball seemed to top the list of sports that lead to shoulder dislocations. Taking a sample of shoulder dislocations from across the country doesn't include everyone but it does give us a peek inside the window. This kind of data can help identify trends of risk and maybe help us develop future prevention strategies. For now it looks like the group to start with are active young men and older adults. Strategies that work best to prevent shoulder dislocations may be the next step in this discovery process. Your own local study could be very useful as well. There must be a reason for the rise in shoulder dislocations. Studies like this might be able to pinpoint what some of those risk factors may be. If possible, once those risk factors are identified, a prevention program might help. Decreasing the incidence of shoulder dislocations would reduce pain, suffering, cost, and loss of income and productivity.

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