Shoulder instability: Causes, symptoms, and treatment

What is shoulder instability?

Shoulder instability is a chronic condition that causes frequent dislocations of the shoulder joint.

A dislocation occurs when the end of the humerus (the ball portion) partially or completely dislocates from the glenoid (the socket portion) of the shoulder.

A partial dislocation is referred to as a subluxation, whereas a complete separation is referred to as a dislocation.

Read on to find out more about the causes and pain associated with shoulder instability, as well as the treatment options available to aid in recovery.

What causes shoulder instability?

Subluxation and dislocation can occur as a result of a sudden injury or overuse, and once it has happened once, the shoulder is vulnerable to repeat occurrences. When it happens repeatedly, it is referred to as chronic shoulder instability.

Sometimes, shoulder instability can occur without a dislocation. These patients tend to have looser ligaments in their shoulders which can be caused by repetitive overhead motion, such as playing tennis, volleyball, and swimming, or working jobs that require overhead work.

Occasionally, patients may just have naturally looser ligaments which result in frequent dislocations and instability.

What are the symptoms of shoulder instability?

The common symptoms of shoulder instability include pain with certain movements of the shoulder, popping or grinding sound (may be heard or felt), and swelling and bruising of the shoulder (this may be seen immediately following subluxation or dislocation).

Visible deformity and loss of function of the shoulder occurs after subluxation, and sensation changes such as numbness or even partial paralysis can occur below the dislocation as a result of pressure on nerves and blood vessels.

How is it diagnosed?

Shoulder instability can be diagnosed through a physical examination, where your doctor will take your medical history and examine the shoulder, and look for looseness in the ligaments. Imaging tests such as x rays and MRIs may also be ordered to find any injuries to the bones or soft tissues.

What treatment options are available for shoulder instability?

Non-surgical treatment options which may help to relieve pain and keep the shoulder active anti-inflammatory medications (such as aspirin and ibuprofen), and changes to activity (avoiding activities that aggravate the symptoms).

Physical therapy may also be helpful for strengthening the shoulder muscles. A therapist can tailor an exercise program to the patient’s needs.

If these treatment options are unsuccessful, surgery may be necessary. There are two types of surgery typically performed for shoulder instability, which are:

Arthroscopy

Arthroscopy is a less invasive surgery performed using small incisions and instruments to repair soft tissues in the shoulder, usually in a same-day or outpatient procedure.

Open Surgery

An open surgery involves making a larger incision over the shoulder to repair the soft tissues.

How long does recovery take?

It depends on the type of treatment, but recovery and rehabilitation from shoulder instability can be a long process, and commitment to following the treatment and exercise plan is required.

If you’ve had surgery, your arm and shoulder will be immobilised temporarily with a sling immediately after the procedure.

Movie – Diagnostic Arthroscopy

Movie – Repair of Detached Labrum

Movie – SLAP Lesion Repair

Further Information

• Chronic Shoulder Instability
• Shoulder Joint Tear (Glenoid Labrum Tear)
• SLAP Tears