Shoulder Instability
Shoulder instability occurs when the head of the upper arm bone is forced out of the shoulder socket due to injury or overuse. Once this has happened, the shoulder is vulnerable to repeat episodes. When the shoulder is loose and slips out of place repeatedly, it is called chronic shoulder instability. Treatment can help to improve stability of the shoulder and reduce the risk of repeat episodes.
-
Symptoms
-
Treatment
Types
There are several types of shoulder instability:
- Shoulder Dislocation: Shoulder dislocation occurs when the humerus (upper arm bone) comes out of the shoulder socket. This is usually caused by an injury or overuse and can cause the tissues to stretch, tear, or detach, leading to instability of the shoulder.
- Shoulder Subluxation: Subluxation is when the humerus partially slides in and out of place. This is usually caused by an injury or overuse and can cause the tissues to stretch, tear, or detach, leading to instability of the shoulder.
- Labral Tear: If the labrum cartilage surrounding the socket of the shoulder joint is torn, it can lead to shoulder instability. A labral tear may occur due to trauma, shoulder dislocation, or from repetitive motions (such as sports).
- Genetic Shoulder Instability: Some individuals born with looser tissues in the shoulder may be more likely to experience shoulder instability even without injury or repetitive motions.
Frequently Asked Questions
Shoulder instability may be indicated if you have chronic shoulder pain along with episodes of instability (such as multiple shoulder dislocations and/or subluxations), as well as feeling that the ball of your shoulder is giving way during certain activities. Patients with a personal history of shoulder dislocation or subluxation are also more likely to have shoulder instability. A medical evaluation with X-rays and other testing (such as MRI) will be performed to diagnose your condition and determine a treatment plan.
Many patients will experience improvement in symptoms through conservative methods. However, patients with a labral tear will likely need surgery as this rarely heals on its own. Surgical candidates also include patients with chronic shoulder instability in their daily lives despite conservative treatments, as well as patients who are not willing to modify their activities to reduce the risk of instability episodes. Factors including the patient’s age, level of function, frequency of dislocation episodes, and lifestyle demands will all play a role in determining whether surgery should be considered.
The most common risks of not getting treatment include persistent pain, weakness, and tension in the shoulder. Recurrent shoulder instability can eventually lead to irreversible damage to the joint, including eventual arthritis. Patients who are not candidates for surgery will be advised to go through conservative treatments to minimize the risk of long-term damage and the recurrence of shoulder instability episodes.