Prescriptions

Navigating a Dislocation
By Cory Johnson

The only thing more painful than having a dislocated shoulder is hiking or paddling with a dislocated shoulder. Generally, you shouldn't fiddle with such an injury; just immobilize it and make haste to the nearest hospital. But if you're in the backcountry and that hospital is more than two hours away, Dr. Peter Goth, founder of Wilderness Medical Associates, says you should try relocating the shoulder first. "Relocating your shoulder immediately reduces the pain," says Goth, "and prevents further injury to nerves, muscles, and ligaments."

Basically, says Goth, "What you want to do is duplicate the position that the arm was in when the shoulder came out." Have the victim lie down and relax as much as possible. Apply gentle, steady traction at the elbow and support the wrist as you slowly--very slowly, taking as long as 15 minutes--move the arm to the "baseball position." Don't force anything; if you encounter stiff resistance or if the pain significantly increases, stop, immobilize the shoulder, and evacuate the victim. Once the arm's in the baseball position, maintain gentle traction and wait for relocation. You'll know it when it happens, says Goth: The k-chunk feel of the ball popping into the socket and the profound relief that comes with it are unmistakable.