Chronic Shoulder Instability

Overview

The shoulder is the most movable joint in your body, allowing your arm to lift, rotate, and reach in many different directions. This great range of motion is prone to instability if there is sudden traumatic injury such as a fall or accident. Once a shoulder has dislocated, it is more susceptible to future dislocations. When the shoulder keeps loosening and slipping out of place, it is called chronic shoulder instability.

 

A shoulder can become unstable in two primary ways:

  • Shoulder Dislocation – is usually caused by severe injury or trauma. The head of the humerus dislocates, causing damage to the socket bone, ligaments, and cartilage in the front of your shoulder. The cartilage rim around the edge of your glenoid called the labrum can tear. This is called a Bankart lesion.
  • Hyperlaxity – is increased looseness in one’s normal anatomy that causes shoulder instability. These patients may never experience dislocation, but have looser ligaments in their shoulder. Sometimes, the looseness is a result of repetitive motion like swimming or tennis that challenge the weakened shoulder. This can result in a painful, unstable shoulder. Patients who have naturally loose ligaments may be double-jointed and may feel looseness in multiple directions. This is called multidirectional instability.
Shoulder Diagram for Joints and Bones

Shoulder Diagram

Treatment

Dr. Stowell will discuss your symptoms and medical history. He will examine your shoulder thoroughly to assess the instability in your shoulder. He may order imaging tests like X-rays or an MRI to provide detailed images of your soft tissues.

 

Dr. Stowell will first treat you with nonsurgical options. If these options do not relieve your pain and improve stability, he may recommend surgery. Nonsurgical treatment options may include the following:

  • Activity Modification – changes in your lifestyle to avoid activities that aggravate your symptoms.
  • Non-steroidal Anti-inflammatory Drugs – may be prescribed such as aspirin, ibuprofen, or naproxen to reduce pain and swelling.
  • Physical TherapyDr. Stowell’s in-house PT team will create a program to help strengthen your shoulder muscles to increase stability. An at-home exercise program may also be designed by Dr. Stowell’s team of physical therapists.

 

When nonsurgical methods have been exhausted, Dr. Stowell may recommend surgery to repair the ligaments so that they are better able to hold the shoulder joint in place. After surgery, your shoulder may be immobilized in a sling temporarily. When it is removed, you can begin exercises to rehabilitate your ligaments and improve your shoulder’s range of motion. This will also aid in preventing scarring as the ligaments heal. Your rehabilitation plan with the physical therapists may expand as they add additional exercises to help strengthen your shoulder. Your commitment to adhering to Dr. Stowell’s recovery plan as well as your diligence with physical therapy will determine when you can return to all the activities you normally enjoy.

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