Shoulder Instability

When the shoulder joint is too loose and is able to slide around too much in the socket, it is referred to as shoulder instability. In some cases, the unstable shoulder actually slips out of the socket. If the shoulder slips completely out of the socket, it has become dislocated.

Shoulder instability can happen as a result of a sudden injury, from overuse or from repetitive motions. 

If chronic instability is not treated, it can lead to arthritis of the shoulder joint.

Symptoms of Shoulder Instability 

• A feeling that the shoulder is going to come out of place with certain movements or that the shoulder has shifted back and forth in its socket. 
• There may or may not be pain.
• Numbness or tingling down the arm.
• Clicking, catching or looseness of the shoulder with daily activities -- particularly sports that require throwing or swimming.

Diagnosis of Shoulder Instability 

Your physician will examine your shoulder and discuss your symptoms and medical history. Also:

• X-rays will be ordered.
• A magnetic resonance imaging (MRI) study may be ordered. It will create a better image of the soft tissues and will help your doctor identify injuries to the ligaments and tendons surrounding your shoulder joint.

Treatment for Shoulder Instability 

Treatment depends on the severity of the instability.

Nonsurgical Treatment:

Even nonsurgical treatment for shoulder instability usually requires a program of physical therapy. The goal of therapy will be to strengthen the rotator cuff and shoulder blade muscles to make the shoulder more stable.

Surgical Treatment:

If the shoulder continues to be unstable/loose after appropriate therapy, then surgery is often recommended to stabilize the shoulder. In some cases, surgery is recommended to repair a fracture or acute, large rotator cuff tear.

• Most surgeries can be performed arthroscopically, but if there is significant damage to the bones, a more extensive, bony procedure is recommended.
• There are a number of different procedures used to stabilize the shoulder. These include: Labral repair (Bankart repair), capsulorrhaphy, Laterjet procedure, humeral head and/or glenoid allograft reconstructions.

Post-operative Care:

• If the surgery is performed arthroscopically, it is outpatient surgery and patients go home the same day as surgery. If a large, bony surgery is performed, patients often stay in the hospital 1-2 days.
• Sling for about 1 month post-operatively.
• Patients attend physical therapy to regain range of motion and strength. Therapy is usually necessary for 3-4 months.
• Full recovery is at least 6 months for return to all sports.