Here's a topic that isn't pleasant to think about, but good to consider.

I was recently on a trip where someone tore a ligament in his shoulder (believe it was the coracohumeral ligament) and his shoulder slightly popped out of the socket. The injured paddler put the hand of his injured arm across his chest and slightly pulled on it with his good hand while I was feeling around on his shoulders to see if I could notice a difference between shoulders. While pushing on his shoulder and him pulling, it popped back in.
Luckily it was in a canyon that we could hike out of and a 3.5 mile hike back to the car.

He went directly to the urgent care (an hour away) and got things checked out. Then after visiting with a specialist a couple days later they told him he would need surgery and 6 months recovery time.

This awoke me to the reality of back-country incidents. I felt rather unprepared because I don't know how to put a dislocated shoulder back in. Of course there are many injuries that could occur while in a place like Ernie's Canyon or the Copper and you would literally be "up a creek.."

Anyways - what I'm getting to. Anyone have good advice on how to put a shoulder back in? What do you do if the person is loosing feeling in the hand (tingling) and you are far from EMS?
Thanks in advance

Take a WFR course and learn from a professional in a class setting. It is important to know the details surrounding this sort of injury, your liability as a rescuer (particularly if you are helping someone you dont know) etc. Reducing a shoulder is something you can easily learn to do, but is still beyond the scope of what you are "allowed" to do unless you are a full paramedic. Everyone paddling should have at least a WFA cert. This kind of information is not something you should casually acquire from someone, even if that someone has the proper training.

... how little I knew about how the body works...

Thanks everyone for the info. Now the trick will be to find a WFR course that doesn't want two arms and a leg..

There are many techniques. Some are harder to visualize/remember and I don't know how to do them. But, some of the more difficult techniques are also the most smooth. An experienced ER doctor can often just gently hold the arm just right and slide it back in as if by magic. I don't have those hands. But, here are two techniques that I've used:

1. To reduce your own shoulder dislocation:

Intertwine fingers as if praying. Bend elbow of injured arm to 90deg. Place knee of same side as injury in crook of elbow. Zen relax injured arm and shoulder while pushing out with knee and pulling toward your chest with uninjured arm.

This technique can be done while swimming. Maybe it's best done while swimming since sooner is better. It works like this....dislocate shoulder....swim.....reduce shoulder with knee....swim to shore

The problem is you roll face down during the reduction so you need a good breath and hold your breath while you put your shoulder back in. It's really hard to effectively swim with a dislocated shoulder so it's best to get it back in right away. Also, the main reason reductions fail is the muscles spasm to splint the injury. After the muscles spasm, you have to overcome the muscles to get it back in. This is why in the ER they have to sedate you to get it back in...to get the spasms to relax. There are no drugs usable in the field that can adequately relax the spasm, so the trick is to reduce the dislocation as fast as possible before it has time to spasm/splint itself. 1-2 min is the target time.

2. To reduce someone else's shoulder:

Lay injured person chest down on a large square rock with injured arm dangling straight down off the rock's edge. Gently but gradually more firmly pull arm by wrist straight down toward ground. The traction should be gentle but firmly progressive, working to overcome the muscle spasm. It's not unlike stretching out a charley horse in the calf. Once the muscle spasm is overcome and the muscles give the shoulder will relax and slide back in. It is very important not to do anything violent or fast/aggressive. Gentle, firm, consistent until the muscles give and the shoulder goes back in.

The complications: Nerve injury resulting in numbness to arm/hand from the nerve being trapped/pinched. Accidentally pulling on a fractured shoulder. Of course, we have no xray in the wilderness, so you work with what you got. If it feels crunchy, leave it alone as it may be broke'.

With good access to healthcare, my opinion is to make one good effort at getting it back in, and this effort should be done as soon as possible after the dislocation. Like, right away, not 20 seconds later. If this fails, and you can walk out, that's likely better. An xray to rule out fracture and some sedation in the ER is a more gentle way of fixing this. If you are truly isolated, it may be ok to spend more time on it. You're really just trying to overcome the muscle spasms. The more built and muscular the person, the harder it is because strong pecs/lats/traps/deltoids, etc are hard to overcome.

I've also seen people who are convinced they have a dislocation, but who do not. So, that's a possibility too.

Well...that's all I have for now....Jim

Yeah, there are many ways to skin this cat.

In any case, it should also be noted that there are shoulders that skilled doctors still have great difficulty reducing even with a deep level of sedation. So, knowing a good technique doesn't mean it will be reliably successful. Failing to reduce a shoulder on the first try or two does happen in the ER. So, in the field, the success rate predictably may end up lower.   Our only advantage is the opportunity to get it before it spasms. After that, it's a tough row to hoe. But, one that's worth digging into.

Have awesome days...and intact shoulders...Jim

It occurred to me, a technique for the multi day crowd for a really stuck shoulder in a very isolated place with days until rescue...I wonder how effective alcohol would be at getting the person's muscles to relax.

Use my technique #2, but get patient fall-down-drunk on alcohol.

Then do #2 by tying a ten pound weight to the wrist and letting it dangle for as long as necessary until the spasmed muscles fatigue and give way to allow the shoulder to reduce. Any benzo on hand like valium/ativan from your boater friends with anxiety might also be helpful.

I guess this isn't really the recommended method, but may someday come in useful in some really isolated place. I am not sure how well alcohol works as a muscle relaxer, so it's benefit may be questionable.

Of course, the drunk patient would then have to be watched very closely and left in the "recovery position" until sober. The main risk would be vomiting and aspirating/respiratory arresting.

Jim