The shoulder joint has one of the widest ranges of motion in the body. It allows the arm to lift, turn, and rotate. Shoulder instability can occur when the head of the upper arm bone is forced out of the shoulder socket, causing dislocation of the shoulder. This usually happens as a result of sudden injury to the rotator cuff muscles during sports or from a forceful fall.
After a shoulder and upper arm bone has been dislocated once, the protective soft tissue becomes damaged causing an unstable shoulder more vulnerable to repeated dislocations.
Shoulder instability can also be caused due to rotator cuff tears, fractures to the bones in the shoulder, or a labral tear.
Patients who suffer from chronic shoulder instability may experience the following symptoms:
- Swelling at the shoulder joint
- A numbing sensation
- Shoulder pain which can limit shoulder movement and range of motion
- Weakness in the arm or shoulder
- Bruising or coloration around the shoulder
- Recurrent instability
There are multiple types of shoulder stabilization including both non-operative and minimally invasive options. For most shoulder dislocations, an emergency room physician can “pop” the bone back into place. However, if an individual has a history of recurrent shoulder dislocation and their arm frequently moves out of the socket, arthroscopic shoulder surgery (also known as shoulder arthroscopy) may help. This is a common surgical procedure that can offer your shoulder stability.
During a shoulder instability procedure, labral tears are repaired, and surrounding bones are restored. The shoulder instability is corrected and repositioned preventing future posterior instability problems or anterior dislocation from occurring.
Shoulder stabilization is a minimally invasive procedure that is done under general anesthesia. Shoulder instability surgery is typically performed as an outpatient procedure, so patients can expect to go home the same day. The arm will be immobilized in a sling for four to six weeks or longer depending on the discretion of your physical therapist.
Some pain, discomfort, and limited mobility should be expected a few weeks after surgery but pain medication will likely be prescribed to help with pain relief along with motion exercises to strengthen soft tissues. Most patients who go through shoulder surgeries can expect to return to competitive sports after recovery.
Participation in physical therapy is important to help strengthen and restore the shoulder’s mobility. Dr. Goldberg’s practice recommends a rehab protocol that encourages patients to perform specific exercises the first day after surgery and start physical therapy within a week of their operation. Implementing a rehab protocol enables patients to return more quickly to their daily activities.
Schedule a Consultation
When experience matters, contact Dr. Goldberg to assess and determine the best treatment options for you. He is a board-certified orthopedic surgeon who has performed over 2000 shoulder arthroscopic procedures, making him one of the most experienced surgeons in the Southwest Florida area. Schedule an appointment today!
Frequently Asked Questions About Shoulder Dislocation and Instability
What is a shoulder dislocation?
A shoulder dislocation is when the ball of the shoulder jumps completely out of the socket and usually injures the tendons or ligaments in the shoulder that normally hold the ball centered in the socket. It typically occurs during a violent accident or significant injury, such as a fall, a tackle, or getting pulled hard.
What is the difference between shoulder dislocation and shoulder instability?
Shoulder dislocation refers to a specific event where the ball comes out of the socket. Shoulder instability is a more general term referring to the whole spectrum of problems where the ball does not stay centered in the socket, which includes partial dislocation, or subluxation, and the conditions where the patients feel their shoulder is sliding slightly in and out of the socket with different activities. Both shoulder dislocation and shoulder instability are things that an orthopedic specialist treats on a regular basis.
Can a dislocated shoulder fix itself?
When the shoulder is fully out of the socket, especially the first time, it usually requires an emergency room visit or other medical professionals to pop the shoulder back in. This is usually done in the emergency room or by a paramedic.
How common is shoulder dislocation and shoulder instability?
Shoulder dislocations and instability usually happen for the first time in patients in their teens and 20s, especially while playing sports. There are certain medical conditions where patients have excessively loose or lax ligaments, which causes their shoulders to be more at risk for dislocation. Shoulder dislocations become less common as people enter their 30s and beyond and increase again as patients enter their 70s, as rotator cuff tears weaken the supporting shoulder muscles.
How do doctors treat a dislocated shoulder?
Usually, to reduce a fully dislocated shoulder, the patient is given some form of mild anesthesia and the shoulder is pulled back into place. Do not try this at home.
What happens inside the shoulder when it is dislocated?
Normally, the ball and socket are centered in the shoulder by their natural, concave shape and surrounding ligaments and cartilage further hold them into place. When the shoulder dislocates fully, it will frequently tear the surrounding structures, most commonly the labrum and the ligaments, and sometimes a fragment of bone gets broken off in the process too. Once those structures are torn, it is common that the shoulder will dislocate again and surgery may be required. When these structures are not repaired, this can lead to more dislocations and further shoulder damage.
How long do you wear a sling for a dislocated shoulder?
Depending on the situation, a sling will usually be required for 3 weeks.
Can shoulder instability heal on its own?
Frequently, as patients reach their 30s and 40s, mild instability decreases as their bodies are less flexible than they were in their teen years. However, if there are significant damaged structures, such as a torn labrum with bone loss, there is a significant risk of instability.
What does a partially dislocated shoulder feel like?
A partially dislocated shoulder feels like something is slipping in and out of the socket inside the shoulder. This can be painful or just annoying.
Will my shoulder ever be the same after dislocation?
Yes, properly treated, even in situations that require surgery, can be healed and the patient can return to activity, including contact sports such as football and martial arts.
Can shoulder dislocation heal on its own?
Frequently, patients are treated after initial shoulder dislocation with physical therapy and return to activity, but this depends on the severity of different structures being injured inside the shoulder. Your orthopedic surgeon will likely order an MRI to determine the extent of damage inside the shoulder.
What is the surgery to treat shoulder instability?
The most common surgery is to repair the torn labrum and tighten ligaments that have been stretched. If there is significant damage to the socket bone that occurred at the time of the dislocation, then additional procedures to repair the ligaments along with supporting the lost bone, such as a Latarjet or tibia allograft, are used to replace missing bone. Your orthopedic surgeon can explain if these procedures are right for you.