Shoulder Instability

Common symptoms of shoulder instability include:

• Recurrent Shoulder Dislocations or Subluxations: This is one of the hallmark signs of shoulder instability. The shoulder may pop out of its socket (dislocation) or partially slip out (subluxation). These episodes can be painful and often require manual reduction to put the joint back into place.
• Pain: Individuals with shoulder instability often experience pain, which can range from mild discomfort to severe, sharp pain. Pain is typically felt in the shoulder joint and may radiate down the arm.
• Feeling of Instability: Patients may describe a persistent sensation that their shoulder is loose or unstable. They might feel like the shoulder is “giving way” or that they can’t trust it during certain movements.
• Weakness: Muscle weakness, particularly in the shoulder and upper arm, is common with shoulder instability. This weakness can affect daily activities and sports performance.
• Decreased Range of Motion: Individuals with shoulder instability may have limitations in their range of motion, especially when trying to move the arm in certain directions, such as raising it overhead or rotating it outward.
• Popping or Clicking Sensations: Some people report hearing or feeling popping, clicking, or grinding sensations in the shoulder when they move it. These noises can be indicative of joint instability.
• Muscle Spasms: Muscle spasms or involuntary contractions of the shoulder muscles may occur as the body attempts to stabilize the joint.
• Numbness or Tingling: In some cases, nerve compression or irritation may lead to numbness or tingling sensations in the arm or hand.
• Swelling and Bruising: After a dislocation or subluxation event, the shoulder may become swollen and bruised due to tissue inflammation and damage.
• Difficulty with Daily Activities: In severe cases, shoulder instability can interfere with everyday tasks, such as reaching for objects, lifting, or even dressing, leading to functional limitations.

Understanding the underlying causes of shoulder instability is crucial for accurate diagnosis and effective treatment. There are two primary types of shoulder instability: traumatic and atraumatic.

• Traumatic Instability: This type of instability typically results from a sudden and forceful injury to the shoulder joint. It is commonly seen in sports-related incidents or accidents. Traumatic instability may cause damage to the ligaments, labrum, and/or bone structures of the shoulder, leading to recurrent dislocations.
• Atraumatic Instability: Atraumatic instability, on the other hand, is often associated with underlying structural factors that predispose an individual to shoulder problems. These factors may include ligament laxity, muscle imbalances, or connective tissue disorders. Atraumatic instability can manifest gradually and may not involve a specific injury event.

Accurate diagnosis is the cornerstone of effective management of shoulder instability.

Your Hyper Regen Sports Medicine physician will conduct a thorough physical examination to assess the patient’s range of motion, stability, and signs of shoulder instability. Special tests may be performed to assess anterior, posterior or multi-directional instability.

X-rays, magnetic resonance imaging (MRI), and computed tomography (CT) scans are valuable tools for visualizing the structures of the shoulder joint. These imaging studies can help identify bone abnormalities, labral tears, and soft tissue damage.

The management of shoulder instability depends on various factors, including the type and severity of instability, the patient’s age, and their activity level. Treatment options include:

• Non-Surgical Treatment: Conservative approaches may include physical therapy to strengthen the shoulder muscles and improve stability. Additionally, the use of a shoulder brace or sling may be recommended to immobilize the joint temporarily, especially during high-risk sporting activities like football.
• Surgical Intervention: Surgery is often necessary for recurrent or severe cases of shoulder instability. Surgical options include arthroscopic procedures to repair damaged ligaments or labrum, as well as open surgical techniques (i.e. Latarjet procedure) in more complex cases.
• Rehabilitation: Regardless of the chosen treatment path, rehabilitation plays a crucial role in recovery. Physical therapy is essential to restore range of motion, strength, and functional stability of the shoulder.