What is Shoulder Instability?

  • The shoulder is the most moveable joint in your body.
  • Shoulder instability occurs when the head of the upper arm bone is forced out of the shoulder socket. This can happen as a result of a sudden injury or from overuse.
  • Once a shoulder has dislocated, it is vulnerable to repeat episodes

There are three common ways that a shoulder can become unstable:

Shoulder Dislocation

Trauma or severe injury, is the leading cause of a shoulder dislocation. When the head of the humerus dislocates, the socket bone and the ligaments in the front of the shoulder are oinjured. After a dislocation, the shoulder may experience continued dislocations, giving out, or a feeling of instability.

Repetitive Strain

Occasionally, people with shoulder instability have never had a dislocation. Many of these patients play sports such as swimming, tennis and volleyball that require repetitive overhead motion that can stretch out the shoulder ligaments. Many jobs also require repetitive overhead work.

Multidirectional Instability

In a small number of patients, the shoulder can become unstable for no apparent reason. In a small minority of patients, the shoulder can become unstable without a history of injury or repetitive strain. In such patients, the shoulder may feel loose or dislocate in multiple directions, meaning the ball may dislocate out the front, out the back, or out the bottom of the shoulder. This is called multidirectional instability. These patients have naturally loose ligaments

Our Treatment Approach

Conservative treatments are used first to treat shoulder instability. If these options do not relieve the pain and instability, surgery may be needed.

Nonsurgical Treatment

It can takes many months of nonsurgical treatment before you can tell if it is working. Nonsurgical treatment usually includes:

  • Non-steroidal anti-inflammatory medication. Drugs like aspirin and ibuprofen reduce pain and swelling
  • Activity modification. You must make some changes in your lifestyle and avoid activities that aggravate your symptoms.
  • Physical therapy. Strengthening shoulder muscles and working on shoulder control can increase stability. Your therapist will design a home exercise program for your shoulder.

Surgical Treatment

Surgery is often needed to repair torn or stretched ligaments to better be able to hold the shoulder joint in place.

  • Arthroscopy. Soft tissues in the shoulder can be repaired using minimally invasive surgery with tiny instruments and small incisions. This is an outpatient procedure.
  • Open Surgery. Some patients may need an open surgical procedure. This involves making a larger incision over the shoulder and repairing the shoulder under direct visualization.

Causes

There are three common ways that a shoulder can become unstable:

  • Shoulder Dislocation
  • Repetitive Strain
  • Multidirectional Instability

Symptoms

Common symptoms of chronic shoulder instability include:

  • Pain caused by shoulder injury
  • Repeated shoulder dislocations
  • Repeated instances of the shoulder giving out
  • A persistent sensation of the shoulder feeling loose, slipping in and out of the joint, or just “hanging there

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