Shoulder Instability

Shoulder instability can occur when the ligaments or tendons that stabilize the shoulder have become loose or have torn. The head of the upper arm bone, called the humeral head, can come out of the glenoid, or shoulder socket if the shoulder is unstable. Shoulder instability can also disrupt the proper positioning of the humeral head. If the humeral head is not centered within the glenoid, it can cause pain. Shoulder instability can result from a sudden injury or overuse.

Chronic shoulder instability can lead to a number of problems, including frequent dislocations, pain, weakness, and loss of shoulder function. For pitchers, chronic shoulder instability can also lead to a condition called dead arm syndrome, which weakens the shoulder and affects pitching velocity.

At FORM Ortho, we offer both surgical and nonsurgical treatment of shoulder instability. Our orthopedic surgeons have extensive training and experience in treating shoulder instability, performing stabilization procedures on a regular basis.

Anatomy of the Shoulder

The shoulder is considered a “ball and socket” joint, with the ball-shaped humeral head of the upper arm fitting into a glenoid. Because the glenoid is small and shallow in relation to the humeral head, it relies on ligaments, tendons, and muscles for stability.

Ligaments connect the humeral head to the glenoid and work with muscles and tendons to keep the humeral head articulating with the glenoid in a normal fashion. Injuries to these tissues can result in shoulder instability.

How Does the Shoulder Become Unstable?

Shoulder instability results from traumatic injuries or repetitive strain of the ligaments, tendons, and muscles stabilizing the shoulder. Over time, this condition can lead to pain, weakness, and loss of shoulder function. When the supportive ligaments are loose, the shoulder is more prone to partial dislocation, known as subluxation, or complete dislocation. If you have dislocated your shoulder previously, you are more likely to have repeat dislocations. The recurrence rate for shoulder dislocation after the initial episode can be over 90 percent in younger patients.

Without proper treatment, shoulder instability can get progressively worse over time. If you experience weakness or feel that your shoulder is loose or “giving out,” you should seek medical treatment. If your shoulder is dislocated, please go to the emergency room.

Treatments for Shoulder Instability

At FORM Ortho, our fellowship-trained orthopedic surgeons offer both surgical and nonsurgical treatment options for shoulder instability. Following a consultation, your physician at FORM Ortho will discuss recommendations for treatment.

Nonsurgical Treatment

Nonsurgical treatment is generally the first course of action for shoulder instability and first-time dislocations. Nonsurgical treatment may involve activity modification, NSAIDs like aspirin or ibuprofen, and physical therapy.

During nonsurgical treatment, you may need to avoid activities that make your symptoms worse. Your orthopedic surgeon may also recommend working with our team of physical therapists to improve stability and strengthen your shoulder, particularly the rotator cuff. For the convenience of our patients, FORM Ortho offers on-site physical therapy to allow for greater communication between your doctor and your physical therapist and to ensure that you receive high-quality care throughout the entire treatment process.

With nonsurgical treatment, it can take time to see results. However, if there is little to no improvement after a prolonged period of nonsurgical treatment, surgery may be recommended.

Surgical Treatment

Surgical treatment for shoulder instability may be done arthroscopically or as an open procedure. Our physicians make surgical recommendations based on the patient’s needs and the extent of damage in the shoulder.

When possible, arthroscopic techniques are used to treat shoulder instability, as this approach is less invasive than open surgery. Open surgery requires a larger incision, whereas arthroscopic surgery uses a small camera to view structures inside the shoulder. This approach allows for much smaller incisions and also allows for quicker recovery times.

Sometimes, the shoulder injury involves bone in addition to the ligaments. In these cases, an open bone block, such as a Latarjet procedure, may be considered. This procedure typically requires open surgery.

What can you expect after shoulder surgery?

The shoulder is often immobilized in a sling after surgery. After an initial healing period, patients begin physical therapy to strengthen the shoulder and help with range of motion. With on-site physical therapy, we are better able to help patients throughout the recovery process.

Following surgery for shoulder instability, the majority of patients are able to return to normal activities in approximately 3 to 6 months. In some cases, particularly for those who have not had surgery, activity modification may be necessary to prevent recurrent dislocations.

Shoulder Instability Treatment in Fremont, California

At FORM Ortho our orthopedic surgeons treat a full range of orthopedic conditions, including shoulder instability. If you have any questions about treatment or would like to schedule an appointment with one of our orthopedic surgeons, please contact us