The luxation of the shoulder can happen when an intense impact tears the previous area of the capsule of the joint of the shoulder, what provokes the exit in previous direction of the head of the humerus (the principal bone of the arm). There exist two mechanisms that can produce a previous luxation of the shoulder:

• for a fall on a hand in hyperextension
• for the collision with a player (or with an object) when the shoulder is in rotation external and separated from the body.

The shoulder also can luxarse in later sense, but the most frequent luxation is the previous one.

One speaks about subluxation of the shoulder when the humerus slides outside of his joint, but then it diminishes in a spontaneous way. The later subluxations observe more often in the sportsmen that they realize repetitive movements of the hand up, how the swimmers, surfistas, players of tennis and pediment.

Diagnosis. The sportsmen with a previous luxation of the shoulder "notice the bulging shoulder" and present a very intense pain. They are unable to rotate the arm and they present a hollow region just below the acromion (the principal bundle of the shoulder), together with a previous bulkiness caused by the displacement ahead of the head of the humerus.

Treatment. The previous luxation of the shoulder needs a rapid treatment for manipulation. Generally, an assistant places a towel long and doubled about the armpit of the side luxado, and while the assistant applies a soft haulage, the doctor exercises a haulage following the axis of the member luxado. The above mentioned haulage must increase in a gradual way during several minutes. If the reduction is successful, one listens to a peculiar noise when the head of the humerus enters again his joint. If the maneuver is realized immediately, the luxation must diminish in 2 ó 3 minutes. Next, it is necessary to realize cross-check radiographies.

In another manipulation skill, the patient is placed in recumbent prone (knocked down mouth below) on a flat surface and with the arm hanging.

Later, 2 kg weight is hung of the hand. This way, the reduction is obtained usually within 20 minutes. If these first attempts of reduction are not successful, the reduction can be proved under analgesia or it anesthetizes in urgencies. In the patient with the first luxation, the shoulder must be immobilized during 2 to 3 weeks. By means of the rehabilitation the relapses can be diminished (that are the biggest problem of the luxations of shoulder).

This injury consists of a temporary malfunction of the nervous structures of the called brachial plexus (a set of nervous roots that they salt of the spinal cord and that are vital for the inervación of the arm) after a traumatism in the head, the neck or the shoulder.

They happen in diverse sports, as the soccer, the rugby, the wrestling, the ice hockey, the ski, the cycling, the motorcycling and the equestrian sports. Probably there are different the mechanisms that they contribute to the injuries of the brachial plexus: side push-up of the cervical marrow, depression of the shoulder and direct traumatism in the area cervicobraquial.

Diagnosis. The injuries of brachial plexus usually study with sensation of "intense heat" or "twinges", The sportsman usually notices an intense burning pain in the shoulder, with pins and needles radiated to the arm and the hand. Also it can collaborate to sensitive shortfalls (anesthesia of some areas of the arm or hand), and weakness of the muscles of the arm or hand.

Treatment. If the neurological shortfalls disappear in a few minutes, the sportsman can play again. In 5 % to 10 % of the patients, the symptoms and signs persist; in such cases it is necessary to look for the help of a neurologist, traumatologist, or of a specialist in rehabilitation.