Toddler might have dislocated shoulder? How to respond to this common emergency

After cutting her own hair and snipping the curly locks off her sister, I picked Emma up by her forearm to remove her from the situation.

She sat on top of the loft bed crying as I dealt with the aftermath. She usually bounces back pretty quickly, especially for a stubborn two and a half year old.

But she was beside herself. 

I grabbed some clothes and was talking to her in the process. “Let’s go outside,” I said as I pulled clothes out of her bins. “Let’s reset. Let’s calm down. We all need it.” I then walked over to the loft to help her put on some play clothes… only she wouldn’t lift her arm.

Sheer horror overtook me as I thought I dislocated my own toddler’s shoulder. 

Panicked, I grabbed an ice pack (covered in a cute little preemie onsie) from the freezer and scrambled to call my husband at work. I rushed over to the neighbor’s house to get a ride to urgent care, the emergency room, or anyone that could handle pediatric dislocations. At the same time another neighbor (who happened to be in pediatrics) pulled out of her driveway. She assured me it was most likely a nursemaid’s elbow and not the shoulder and reassured me that I wasn’t a bad mom.

Did I dislocate my toddler’s shoulder? Probably not, but elbow injuries are relatively common.

Dr. Barbara Bergin, M.D. and Board Certified Orthopedic Surgeon out of Austin, TX told me that “It doesn’t require a violent incident, and can occur with a relatively light pull and that even a “light tug, can result in subluxation or dislocation of the radial head in a toddler.”

And we have all done something that could slip the elbow out of place in a child. Everything from picking them up, swinging them, or letting them climb us like stairs while we hold onto them. It can even happen while playing, from roughhousing with a parent, or any number of stressors on the arms.

The term “nursemaid’s elbow,” is the idea that the nursemaid was pulling or tugging on the child to get them to hurry. Physical Therapist, Patrick Tarnowski, explains that “the technical term is “Radial Head Subluxation” and while the name sounds scary, it’s very common in children ages 1-4.”

What to do if you suspect your child has nursemaid’s elbow.

Don’t panic & assess the situation

I’m not well versed in that because I was crying and scurrying around in horror.

However, in kids ages 1-6 with no extreme circumstance leading to the injury, it’s probably not a shoulder dislocation. As the nurses explained to me, because Emma could stretch her arm over her head and was even hiding it behind her back, she had full rotation and it wasn’t her shoulder.

But at home it was limp and I couldn’t get her to move it. And I couldn’t feel her shoulder blade. 

Grab some ice

Dr. Bergin explained that in the case of a nursemaid elbow your toddler will “suddenly complain of pain and be unwilling to move the arm, holding it straight, and close to their side.”

So simply icing it while you make a phone call or two before hoping in the car is a good thing.

Phone it in (it’s important, here’s why…)

We walked into the closest Urgent Care facility in the area and I mentioned what happened. They said “we can take an x-ray, but if it’s dislocated, there’s nothing we can do.”

So we trekked over to the nearest hospital that also had an urgent care attached.

They were able to diagnose and treat the subluxation without an x-ray, thus saving from irradiating my daughter unnecessarily. This differed that exposure which I really appreciated, especially since she was her normal self within 2 seconds of them shifting it back into place.

Therefore, go ahead and call your doctor or urgent care to see if they are familiar with it (of course assuming that it’s nothing worse) and see if they require an x-ray or not.

Follow your doctor’s orders

For us, they handed out popsicles, laughing that I probably needed one most. And then they told us to ice and elevate as needed.

They also warned that for some, it becomes more common once it happens the first time, but for others it’s a one time thing that’s no big deal.

Inform other caregivers of what happened

Because it could happen again, let them know. They should be aware so they can ice it or just to be a little extra cautious. So if you’re going out anytime soon, add it to your babysitter’s notes.

Succinctly put… Nursemaid’s elbow, while frightening, resolves very well. 

Get the printable babysitter guide to post on your refrigerator when leaving the kids at home with a caregiver! (There’s a sneak peek and the sign-up below the picture.)

 

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