Shoulder Instability

///Shoulder Instability

An Overview of Shoulder Instability

As the most mobile joint in the human body, the shoulder allows a wide range of motion for everyday, work and athletic activities. This great range of motion does have a downside – it can cause shoulder instability. With shoulder instability comes the increased risk of shoulder dislocations. The shoulder specialists at Texas Sports Medicine are available to return active individuals living in the Dallas, Frisco and Fort Worth, Texas area to the game they love following chronic shoulder instability.

What is Shoulder Instability?

Shoulder instability is characterized by a shoulder joint that is too loose and is able to move around within the shallow socket. If the shoulder slides completely out of socket, a dislocation occurs.

Shoulder instability is often the result of an injury that caused a dislocation, as well as continued overuse of the shoulder joint. In many cases, a dislocation that causes instability is severe enough to require a medical professional to reduce (manually put the upper arm bone back in the socket) the joint. This level of dislocation has the ability to stretch or tear the ligaments and the labrum that hold the joint in its proper place. When the surrounding supporting structures become loose, the shoulder cannot remain in the socket when moved in certain positions.

Chronic shoulder instability occurs when the shoulder is too loose and the joint continues to dislocate.

Shoulder Instability Symptoms

A chronic case of shoulder instability causes a number of symptoms, including:

  • Frequent subluxation (shoulder may sublux (slip) in certain positions)
  • Looseness of the joint
  • Pain in and around the joint
  • Repeated dislocations

Shoulder Instability Treatment

Patients with chronic shoulder instability often begin treatment with conservative options. If the nonoperative options do not relieve joint pain and instability, surgery may be recommended.

Nonoperative

  • Activity modification
    • Make daily lifestyle changes that aggravate the symptoms
  • Rest
    • Stop any athletic activities that require a wide range of motion from the shoulder joint
  • Non-steroidal anti-inflammatory medication
    • Use medications such as ibuprofen and aspirin to reduce pain and swelling
  • Physical therapy
    • Follow a program designed to strengthen the shoulder muscles and work on shoulder control movements

Operative

  • Bankart repair
    • Surgical technique: Involves re-anchoring and suturing the torn piece of cartilage to restore stability to the affected shoulder joint. This technique is often recommended in patients with anterior shoulder instability.
  • Shoulder stabilization
    • Surgical technique: An arthroscopic technique is generally used to repair and secure the damaged ligaments and surrounding labrum to restore joint stability.
  • Latarjet procedure
    • Surgical technique: Addresses loss of bone stability and ligament injury by using three main principles that create stability. 1.) The coracoid process is transferred to the front of the shoulder blade to restore the bony defect of the glenoid surface. 2.) The inferior subscapularis and anterior inferior capsule are reinforced, allowing the conjoined tendon to provide additional anterior stability when the arm is rotated. 3.) The capsule is reattached to the bone graft inferiorly.

After Surgery

  • Sling will be used for up to four weeks
  • Therapy will begin slowly and progress through range of motion (ROM) exercises and strengthening exercises
  • Overhead athletes can begin gradual return to play at 3-4 months
  • Full return to play is between 4-6 months

If you live in the Dallas, Frisco and Fort Worth, Texas area and would like additional information on shoulder instability, please contact the shoulder specialists at Texas Sports Medicine today.

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