Videos
If a picture says a thousand words, then we think a video is worth ten thousand! Rather than simply describing techniques, here are real life examples of shoulder reductions performed on real patients, as well as video walkthroughs of reduction techniques performed on models. If you have a video you would like us to feature, please contact us.
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 Here a shoulder reduction is attempted, however the operator is unable to get the patient to adduct. This is not uncommon. Neil Cunningham walks through troubleshooting this problem and manages to manoeuvre the shoulder into position for relocation. Check out more on analgesic positions here. |
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| This video shows a shoulder reduction being attempted, using non-sedating methods. However, it is unsuccessful, and eventually a touch of sedation is used to control the muscle spasm. This results in a quick reduction. |
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| Neil Cunningham performs a relocation on a patient with an anterior dislocation using the Cunningham Technique. Notice in the video that the arm is held in adduction, and the patient is in Analgesic Position 1. Neil asks the patient if he is in any pain – the patient says no, and he has not been given any analgesia. With the Cunningham Technique there is no yanking or pulling involved, and the traction applied is very gentle. | |
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| Cunningham Technique – with the elbow flexed to 90 degrees. Once again, there is no traction involved, and the patient is asked to relax. The patient has their arm adducted, and is painfree, despite recieving no analgesia. Notice the scar on the anterior part of his shoulder – this patient already had a rotator cuff repair following a previous dislocation. | |
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| Here we have the Cunningham Technique being performed on a patient. Notice the starting position, where the patients arm is slumped to the side with the scapula anteverted (rotated around to the front). Slowly and gently the arm is moved into adduction, and towards Analgesic Position 1. No traction is applied, and the shoulder reduces easily. This patient had no analgesia prior to relocation and had an associated greater tuberosity fracture following a fall from a bicycle. | |
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| Kocher’s Method being performed on a patient in the emergency department by Dr Cunningham. | |
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| Zero Position Technique being performed on a patient in the emergency department by Dr Cunningham. | |
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| This video describes the Modified Milch Method of relocating a shoulder. The modification fixes the scapula so that the zero position can be reached with minimal movement to the affected arm. | |
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| Modified Milch Method. This version is performed from the front of the patient, and often needs an assistant. The modification fixes the scapula so that the zero position can be reached with minimal movement to the affected arm. Notice the gentle traction and arm movements. | |
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| Scapular Manipulation Method. This is a useful technique for those that present with an abducted shoulder or those with a greater tuberosity fracture, as they benefit from Analgesic Position 2. It relies mostly on a cooperative patient and, as the name suggests, rotation of the scapula. One again this technique needs an assistant, and does not require a lot of traction. It can also be performed with the patient lying prone. | |
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| Kocher’s method. Kocher is considered a pioneer in shoulder reduction, and you can see a copy of his original article, translated from German here. Kocher’s method is good for someone who presents with a adducted dislocated shoulder, as it begins by placing them in Analgesic Position 1. Watch the video for a simple demonstration of Kocher’s method. | |
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| This is a video animation of the anatomical structures that come into play with a shoulder dislocation. Click Here for a further description of the anatomy. | |
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| Cunningham Technique – the same video as the second one above, but this time with subtitles, in case you have trouble with the New Zealand accent. | |
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We would like thank the patients and staff who appear in these videos. All patients and staff gave their consent before and after the relocation and agreed for these videos to be used for educational purposes.
Latest Updates
ShoulderDislocation.net has posted two new videos on our YouTube channel and Videos page.
These videos are quite a bit different from the others – in that things didn’t quite go as smoothly as we would have hoped. In both of these shoulder dislocations the relocation was proving to be a little difficult and might prompt abandonment of the techniques in favour of heavier sedation.
The first video shows a patient with in whom the muscle spasm was unable to be overcome with simple positioning and a variety of manoeuvres. She eventually required sedation resulting an a quick reduction
In the second video, the patient has a subglenoid dislocation, and the operator tries to get the patient to adduct the arm. Unfortunately this is difficult, so Neil talks the operator through a series of manoeuvres to manipulate the humerus into the correct position, including attempting Zero Position. Eventually the shoulder is relocated.
This month, Neil Cunningham talks to Scott Weingart from EM-RAP about shoulder dislocation and the various methods of achieving relocation. The podcast is available for subscribers to EM-RAP. Neil focuses particularly on non-analgesic relocation methods, analgesic positioning, and talks about the recent translation of Kocher’s method.
Have you ever been at a footy or rugby match, or on a skifield and seen someone with a dislocated shoulder? Ever wondered whether it is worth trying to relocate the shoulder “in-the-field”, before xrays, analgesia or transfer to a hospital? Have you thought it might be better for the patient if they got their shoulder in sooner rather than later?
This month Gerard Fennessy shares his experiences on a skifield, dealing with in-the-field dislocations. He talks about sedation and analgesia in remote locations, as well as the use of non-traction/countertraction techniques to make the relocation safer for the patient.
Have you ever thought that there must be a perfect position for your patient with a dislocated shoulder? Well, usually there is (and I don’t mean “relocated’, although apparently that is a pretty good position!).
When your patient comes in with a dislocated shoulder, there are several things you can do to give them immediate pain relief. And we are not necessarily talking about morphine or propofol!
This month we look at analgesic positions for your patient – ones that provide near immediate relief of pain, before you can shout “Get a drip in!”.
Have you ever wanted to teach your patients how to relocate thier own shoulders? Well now you can! The Boss-Holzach-Matter technique is an autoreduction technique that you can teach your patient to do, directly in the Emergency Department. This simple-to-teach technique also has a patient handout that you can print out.
