Shoulder Instability

What is shoulder instability?

Shoulder instability is a condition in which the ball of your upper arm bone comes out of your shoulder socket (dislocates) on a regular basis. After a first shoulder dislocation, you're quite likely to experience the problem of chronic shoulder instability if you don't seek treatment.  Sometimes the shoulder doesn't come completely out of the socket and this is call partial instability.

Shoulder instability is usually related to an injury, such as a tear in your shoulder labrum. The labrum is a cartilage ring around your joint socket. It helps your upper arm bone to remain in place similar to a bumper in a bowling lane.  A tear in the labrum allows too much movement, and that can lead to shoulder instability. 

Labral tears frequently occur at the same time as other shoulder injuries, like rotator cuff tears, which can further increase the risk of shoulder dislocation leading to chronic instability. 

Some people have naturally loose shoulder ligaments, a condition called hyperlaxity. If you have this problem, you may develop shoulder instability even if you never have a dislocation.  

What are the symptoms of shoulder instability?

If you have shoulder instability, you may experience:

• Excessive shoulder movement, like frequent slipping in and out of the socket
• Decreased shoulder range of motion
• Shoulder weakness
• Pain with certain motions, like reaching up
• Loose-feeling shoulder joint

While the shoulder dislocation itself isn't necessarily painful, the injury behind it, for example, a labral tear, can be quite painful. It can also be rather scary to feel like your shoulder is unreliable. 

What is the treatment for shoulder instability?

Dr. Jonathan Koenig evaluates your shoulder instability and then makes treatment recommendations based upon the particular injury, your recovery goals, and your personal preferences. 

In most cases, non-operative treatments are the first-line approach. This usually includes physical therapy, anti-inflammatory medication, activity modifications, and occasoinally corticosteroid or PRP injections. 

If your shoulder instability and resulting pain don't improve with conservative treatments, Dr. Koenig may recommend surgery. In most cases, he treats shoulder instability and its connected injuries using minimally invasive arthroscopy. This approach uses tiny openings in the skin rather than long incisions.  We use a fiberoptic camera smaller than a dime to look inside the shoulder and use similarly sized instruments to complete the surgical repair and stabilization.

You'll wear a shoulder sling after surgery, which helps to stabilize the joint as your shoulder heals. Dr. Koenig recommends physical therapy to safely improve your shoulder strength and range of motion afterwards. Physical therapy also helps you to return to healthy flexibility without putting your joint at risk again. 

Shoulder instability need not hold you back from all of the activities you enjoy. To get help from an esteemed orthopedic surgeon who customizes your care for your personal needs, call Jonathan H. Koenig, MD, or click on the provided appointment link now.