This is a great, drug free way to reduce a shoulder, invented by Neil Cunningham. As Neil mentions in his definitive talk about shoulder dislocation and reduction, there may be times when you elect not to use this technique, but in patients with minimal pain/spasm, who can get their arm into the adducted position, it’s worth a shot if it avoids a potentially unnecessary procedural sedation.
- Have the patient sitting as upright as possible
- Get the arm as adducted as possible – patient’s elbow as close to their side as they can
- Continually remind the patient to sit up straight, take slow deep breaths and relax their shoulders
- Shorten the biceps by flexing the patient’s elbow and rest their hand on your forearm/shoulder – this will prevent it pulling the humeral head medially
- Massage the trapezius, deltoid and biceps
- You won’t feel the classic “clunk” you get with traction techniques – but you will see the “step” disappear.