LA Orthopedic Group can restore range of motion and strength in cases of Shoulder Instability.
If shoulder muscles, ligaments, and tendons do not provide sufficient support to the shoulder joint, it’s referred to as shoulder instability. Without enough support from soft tissues, the upper arm bone may become dislocated from the shoulder socket.
- Dislocation is one possible cause of shoulder instability
- While there are conservative (non-surgical) remedies that may relieve pain and restore stability, surgery is sometimes necessary to successfully repair ligaments
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Reasons for Shoulder Instability
Sudden trauma from a hard fall or impact may cause a shoulder to be dislocated for the first time, leading to instability. This initial dislocation of the upper arm bone (humerus) from the socket bone (glenoid) may injury nearby ligaments. Cartilage around the socket bone (labrum) may also become torn.
Another possible reason for shoulder instability is repetitive strain, which may occur without dislocation. Ligaments may become loose from overhead motions from activities such as tennis and swimming. Occupation-related movements can have the same effect. Repeated wear and stress on ligaments can make the shoulder unstable.
In some instances, multidirectional instability occurs without previous dislocation or repetitive stress injuries. With this type of instability, the ball-and-socket shoulder joint feels loose in all directions. People who are born double-jointed are at a greater risk of having this type of shoulder instability.
Signs of an Unstable Shoulder
Pain associated with movement of the shoulder is a common sign of shoulder instability, as is a general looseness of the shoulder when making arm movements. Additional symptoms of instability may include:
- Repeated dislocations
- Feeling of the shoulder giving out
- Loose feeling in the shoulder
- Shoulder repeatedly slipping in and out of the joint
A physical exam is usually combined with tests to assess the stability of the shoulder, which may include being asked to make basic shoulder movements. Image tests such as X-rays and MRI scans can confirm instability.
Initial treatment is usually non-surgical unless pain is severe due to a complete ligament tear or related joint damage. Recommendations often include non-steroidal anti-inflammatory drugs (NSAIDs) to reduce swelling around the joint and physical therapy to strengthen shoulder-supporting muscles and ligaments. Some patients also benefit from modifying activities or avoiding movements that tend to lead to a dislocation.
Surgical Treatment Options
Should a shoulder still be unstable after trying conservative treatments, surgery may become an option. For instability caused by minor damage to ligaments in the shoulder, arthroscopic surgery that involves smaller incisions and minimally invasive surgical techniques is often recommended.
When direct visualization of the injured part of the shoulder is needed or if the damage is extensive, traditional open surgery is performed. Rehabilitation usually includes immobilization of the shoulder and physical therapy to restore range of motion and muscle strength.
In general, shoulders can be kept as stable as possible by doing proper warm-ups prior to any activity that will involve repetitious shoulder movements. If shoulder soreness or pain is experienced, giving muscles, tendons, and ligaments time to heal can reduce the risk of weakening any of the tissues that help keep the shoulder joint stable.