What is Shoulder Instability?
Shoulder instability is when the ball and socket joint of the shoulder comes out of place. This can occur once or sometimes can reoccur over a long period of time. Once a shoulder comes out of socket, the shoulder is vulnerable to repeat episodes in the future.
Mechanism of Injury
A shoulder dislocation commonly is the result of an acute traumatic injury in which the shoulder joint is dislocated or when the ball comes out of socket. This can be caused by injuries sustained in sports, like a fall onto the shoulder or if the arm pulled too aggressively or in the wrong direction. It can also occur in other traumatic injuries, like car crashes or falls or be the result of ligamentous laxity that a person is born with.
Diagnosis and Symptoms
Shoulder instability has been equated to as difficult a disease to live as compared to heart disease and diabetes. People are often afraid to do certain activities in fear of the shoulder coming out of place. After any shoulder dislocation or when the ball comes out of the socket, the shoulder joint must be reduced immediately to prevent other injuries to the nerves and blood vessels in the arm. During this dislocation, the shoulder can cause tearing of the labrum, fractures in the shoulder joint, and injuries to the neurovascular structures. A physical exam by a trained professional is recommended. X-ray imaging should be included to rule out fracture and other conditions of the shoulder. Advanced imaging such as an MRI with fluid injected into the joint is done to evaluate the full extent of the injury.
Treatment
The treatment for a shoulder dislocation or shoulder instability is based on the extent of the injury, the presence of any fractures, and the chronicity of dislocations. Initially, non-operative treatment is recommended as long as no bone injury or fracture is seen. This would include rest, sling, ice, anti-inflammatories, physical therapy and slow progression into activities. However, if there is a fracture in the ball or socket, if the shoulder has been chronically unstable and if the shoulder is preventing normal activities, then surgical treatment can be sought. The surgical treatment usually is an arthroscopic (minimally invasive) surgery that tightens the structures (capsule and labrum) in the shoulder. This will help prevent the shoulder from dislocating in the future. This surgical procedure is followed by restricted activities for a period of time and physical therapy to rehabilitate the shoulder. Full recovery usually is 6 to 9 months. This usually is successful in restoring shoulder function and allowing people to return back to sporting activities and normal everyday life.
For more information, please consider the following link that was produced by the AAOS.
https://orthoinfo.aaos.org/en/diseases–conditions/chronic-shoulder-instability