Shoulder Instability: Causes, Treatments, and Recovery

With causes as diverse as athletic injuries, accidents, age, and health, traumatic shoulder instability is a condition that can affect any of us. This condition occurs when the structures of the shoulder joint become unstable and the shoulder cannot be maintained in its proper location. It can lead to shoulder weakness, a loose feeling, an inability to move your shoulder, pain, or partial or complete dislocations. Dr. Jeffrey Berg, Town Center Orthopaedics (TCO) orthopedic surgeon and sports medicine specialist, shares insights into the causes, treatments, and recovery for this condition that can severely impact your life.

Shoulder Instability and You: Everything You Need To Know

The shoulder is a complex and vital joint made up of the humerus (the upper arm bone), scapula (shoulder blade), and clavicle (collarbone). It plays an essential role in our daily lives and overall physical functionality.

The shoulder is essential for:

• Everyday Activities: Tasks like brushing your hair, putting on a jacket, or even preparing meals require an efficient and functional shoulder.

• Athletic Performance: Sports place significant demands on the shoulder joint. A healthy shoulder enables athletes to perform optimally, while shoulder instability or injuries can sideline them and impact performance.

• Upper Body Stabilization: The shoulder also plays a critical role in stabilizing the upper body. This stability is essential for maintaining proper posture and balance, especially in activities that require upper body strength.

“The shoulder is naturally a very loose joint. And so when it is injured, it can become unstable in multiple directions,” Dr. Berg explains.

Shoulder Instability—How Does It Happen?

The most common causes are:

1. Traumatic Injury: A sudden impact, such as from sports injuries or accidents, can lead to a dislocation or significant damage to the ligaments supporting the shoulder joint.
2. Overuse and Repetitive Strain: Repeated overhead activities, common in athletes such as swimmers, baseball players, or gymnasts, may stretch or weaken the shoulder ligaments over time.
3. Congenital Factors: Some individuals are born with inherently loose or lax ligaments, making them more susceptible to instability.
4. Previous Shoulder Dislocations: If a shoulder has been dislocated previously, the risk of future instability increases due to weakened stabilizing structures.

How Does Traumatic Shoulder Instability Differ From Nontraumatic Instability?

According to Dr. Berg, “Nontraumatic shoulder instability typically occurs in people who are naturally loose-jointed, and traumatic shoulder instability occurs after some kind of injury to the shoulder.”

What Symptoms Indicate Traumatic Shoulder Instability, and When Should Patients Seek Medical Attention?

The symptoms associated with shoulder instability can vary but often include:

• A feeling of looseness in the shoulder joint.

• A deformity if the shoulder is dislocated.

• Pain during movement, especially overhead.

• Frequent dislocations or a sensation that the shoulder may slip out of place.

• Swelling and tenderness around the shoulder area.

A healthcare professional will typically diagnose shoulder instability through:

Physical Examination: The physician will assess the shoulder’s range of motion, stability, and strength to evaluate the extent of the instability. The physician will also note any physical deformity, tenderness, and swelling signs.

Imaging Studies: X-rays, MRIs, or CT scans may be ordered to visualize the joint’s structure, check for fractures, and evaluate the condition of the ligaments and soft tissues.

What Are the Primary Treatment Options?

Treatment will depend on the severity of the condition. “If you notice a deformity or feel your shoulder slip out of joint, you should go to the emergency room immediately,” Dr. Berg advises. “If there’s no deformity and you can still move your shoulder, you should see your doctor soon.”

Treatments may include:

Supportive Device: A sling may be recommended as a nonoperative treatment to support, immobilize, and stabilize the shoulder joint.

Physical Therapy: Rehabilitation exercises can strengthen the muscles surrounding the shoulder and improve stability.

Activity Modification: Avoiding specific movements that exacerbate symptoms and opting for low-impact activities can help manage pain and improve function.

Medication: Over-the-counter anti-inflammatory medications may alleviate pain and swelling.

Surgical Intervention: When it comes to shoulder instability, is surgery needed? In cases of severe instability or recurrent dislocations, surgery may be necessary to repair damaged ligaments and reestablish joint stability.

What Does the Recovery Process Involve?

Instability in shoulder recovery varies based on treatment:

Post-Surgery: Patients generally begin physical therapy within a few weeks after surgery, focusing initially on a passive range of motion before progressing to strength training. Full recovery takes approximately four to six months, although this can differ based on the injury.

Nonsurgical Treatment: Recovery may take two to three months, involving gradual rehabilitation exercises to restore mobility and strength.

What Are the Risks of Leaving Traumatic Shoulder Instability Untreated?

Any future complications for shoulder instability that’s left untreated can include:

• Chronic Pain: Ongoing discomfort may persist due to damaged tissues and joints.

• Recurrent Dislocations: The shoulder may become increasingly unstable, leading to multiple incidents.

• Arthritis: Long-term instability can contribute to wear and tear of the joint surfaces, increasing the risk of developing osteoarthritis.

Learn More About Shoulder Instability at Town Center Orthopaedics

Shoulder instability is a manageable condition that can severely impact your quality of life. Proper diagnosis and a tailored treatment plan are crucial for recovery and stability. Watch Dr. Berg’s video for more insights about shoulder instability. If you suspect you may be experiencing shoulder instability, make an appointment to talk to one of our shoulder and elbow orthopedic specialists. (Of course, seek immediate medical help if you believe it’s a traumatic injury.)