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From: bill hansen1 <b2hansen_at_twcny.rr.com>
subject: [Paddlewise] Jacobson's dislocated shoulder treatment
Date: Mon, 13 Jun 2005 07:23:44 -0400
The weight-on-the-arm method described really does work. Perhaps the most 
important thing about it is that it is also *safe*, in the sense that if 
there is a fracture of the humerus (the upper arm bone), the "weight 
method" won't make that worse, while other attempts to relocate the 
shoulder can cause more damage.

I also agree that a 20-25 pound weight is more appropriate  - for an adult 
- than a lighter weight. It can take 30-45 minutes for some dislocations to 
slide back into place using this technique. How much weight it takes and 
how long a time one should allow for it to work, depends on how long it's 
been since the shoulder "came out" and how muscular is the victim. The 
longer the time since dislocation and the more muscular the vic, the longer 
it's likely to take for the shoulder to relocate.

The exception to this might be the case of a person who's had shoulder 
dislocations in the past, which may (or may not) make relocation quicker 
and easier.

Whatever else you do, don't use the old method of putting your foot in the 
person's armpit and pulling on the arm. While that does work in many cases, 
it really can cause severe and lasting damage. It's not worth the risk. The 
same goes for pushing on the head of the humerus, which lies on the front 
of the chest in most dislocations while twisting the humerus around. That 
sounds awful, doesn't it? It works, but it should only be done after an 
X-ray proves that there's no fracture, and it should probably only be done 
by a well-trained technician or other HCP.

Bill Hansen
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