Shoulder Instability

What is Shoulder Instability?

Shoulder instability occurs when the structures that hold the shoulder joint in place are weakened or injured, making it difficult for the humeral head (the ball of the upper arm bone) to stay securely positioned in the shoulder socket (also known as the glenoid cavity or glenoid fossa). This can result in partial or full shoulder dislocations, leading to chronic shoulder instability if not addressed.

The shoulder joint is one of the most mobile joints in the body, allowing for a wide range of motion. However, this flexibility also makes it vulnerable to instability, especially when the shoulder capsule, joint capsule, or ligaments are damaged or overstretched.

Types of Shoulder Instability

There are several types of shoulder instability, each with its own causes and characteristics:

• Traumatic Shoulder Instability: Usually the result of a significant shoulder dislocation due to trauma, such as a fall or sports injury. This often leads to recurrent dislocation.
• Atraumatic Shoulder Instability: Develops gradually from repetitive stress, especially in athletes who engage in repetitive overhead motion, like swimmers or baseball players.
• Multidirectional Instability: Occurs when the shoulder is unstable in more than one direction, often linked to naturally loose ligaments or generalized joint laxity.
• Shoulder Subluxation: A partial dislocation where the humeral head slips slightly out of the glenoid rim but doesn’t fully dislocate. This type of instability may be harder to detect but can still cause significant discomfort.

What Causes Shoulder Instability?

Several factors can contribute to shoulder instability:

• Trauma or Injury: A direct blow or fall onto the shoulder can damage the shoulder capsule, rotator cuff, or labrum, resulting in instability.
• Repetitive Overuse: Continuous overhead activities can stretch and weaken the supporting structures, causing gradual instability over time.
• Genetics: Some people are born with looser ligaments or more elastic connective tissue, predisposing them to an unstable shoulder.
• Previous Shoulder Dislocation: A history of shoulder injuries or recurrent dislocation increases the risk of future instability.

Shoulder Instability Symptoms

Recognizing the signs of shoulder instability is crucial for early diagnosis and treatment. Common symptoms include:

• A sensation that the shoulder is loose, slipping, or may “give out”
• Repeated episodes where the shoulder subluxation occurs or the shoulder fully dislocates
• Shoulder pain, particularly during motion or after certain activities
• Weakness in the shoulder, especially with lifting or reaching overhead
• Clicking, catching, or grinding sensations during movement
• Reduced range of motion or shoulder stiffness

In more severe cases, you may experience compression fractures, nerve damage, or torn or stretched ligaments, especially following trauma.

How is Shoulder Instability Diagnosed?

At Georgia Hand, Shoulder & Elbow, our orthopedic specialists begin with a detailed medical history and physical examination. This includes:

• Assessing your range of motion, strength, and signs of instability
• Specific tests to identify when shoulder subluxation occurs
• Imaging studies such as X-rays (to rule out fractures), MRI (to examine soft tissue like the rotator cuff or labrum), and possibly CT scans (to assess bone damage to the glenoid rim or humeral head)

In some cases, advanced imaging may reveal subtle injuries like a glenoid cavity lesion or rotator cuff tear that contribute to instability.

How is Shoulder Instability Treated?

Shoulder instability treatments typically start with nonsurgical treatment options, especially for first-time dislocations or milder cases. Common strategies include:

• Physical therapy: Focused on strengthening the rotator cuff and stabilizing muscles around the shoulder blade and shoulder joint
• Activity modification: Avoiding movements that aggravate instability
• Anti-inflammatory medications: To reduce swelling and manage pain
• Bracing: Especially useful for athletes during recovery or return to sport

This conservative approach can be highly effective in restoring strength and stability while preventing future dislocations.

When Would I Need Surgical Treatment?

Surgery may be recommended if:

• You experience recurrent instability or repeated shoulder dislocations
• There is significant damage to the glenoid rim, rotator cuff, or joint capsule
• Nonsurgical treatment fails to provide relief or restore function

Common surgical options include:

• Arthroscopic shoulder stabilization: A minimally invasive procedure to repair torn or stretched ligaments, reattach the labrum, or tighten the shoulder capsule
• Open shoulder surgery: For complex or severe cases
• Bone grafting: When bone loss around the glenoid fossa or humeral head is contributing to the instability

At Georgia Hand, Shoulder & Elbow, our surgeons also specialize in elbow surgery and complex upper extremity care, ensuring comprehensive and highly skilled treatment for all shoulder conditions.

Regain Confidence in Your Shoulder Function

Shoulder instability can disrupt daily life, athletic performance, and your overall sense of well-being—but it doesn’t have to be permanent. With expert diagnosis, targeted treatment, and a supportive recovery plan, most patients return to their usual activities without pain or fear of re-injury.

At Georgia Hand, Shoulder & Elbow, our team is here to help you overcome instability and regain confidence in your shoulder’s strength and stability. Whether you’re dealing with a recent shoulder dislocation, ongoing pain, or chronic shoulder instability, we provide personalized care backed by advanced orthopedic expertise.

Don’t let an unstable shoulder hold you back. Schedule an appointment at our offices in Marietta or Atlanta, Georgia, today to start your path to recovery and long-term shoulder health!