Shoulder instability is a condition that causes the shoulder joint to routinely subluxate—that is, partially dislocate—or even dislocate completely during normal activity. It happens when the connective tissue of the joint becomes loose or stretched, allowing the bones to move too freely. It’s a fairly common condition which, if left untreated, can restrict your daily activities and result in limited range of motion or even lead to arthritis of the shoulder.
Shoulder instability usually develops either after a traumatic injury that stretches or tears the ligaments in the shoulder, or from chronic overuse. Repetitive motions such as swimming or pitching a ball can result in shoulder instability. People who are “double jointed” and already have looser ligaments than most, are particularly prone to shoulder instability.
Here’s an overview of what symptoms to look for and the best treatments for shoulder instability from Dr. Francis Mendoza, NYC-based orthopaedic shoulder surgeon.
Symptoms of Shoulder Instability
You may have no symptoms until the shoulder spontaneously subluxates, but more commonly you will have pain during some activities, especially if the instability follows a traumatic injury. Symptoms include:
- Clicking or popping within the joint when it moves
- Weakness during some activities, such as reaching over your head
- Pain during activities that require moving the joint through its full range of motion
- Tenderness to the touch
- Numbness of the arm during activities that involve raising the arm
- Recurrent subluxations
Treatments for Shoulder Instability
There’s a wide range of available treatments for shoulder instability. The first goal is to reduce pain and inflammation with nonsurgical methods, so you may be prescribed rest and anti-inflammatories such as ibuprofen or naproxen. In some cases, a cortisone shot may provide relief. Physical therapy is often recommended; it can help you both strengthen the muscles which help stabilize the joint and retrain your body to move differently so that you don’t unnecessarily stress the joint. Other conservative treatments for shoulder instability may include protective taping, short-term use of a sling, and application of gentle heat or ice.
Depending on your age and the cause of the instability, surgery may be recommended if conservative treatments fail.
Surgical Treatments for Shoulder Instability
Surgical treatments today are much less invasive than they once were. Procedures can be done arthroscopically, which means smaller incisions, less trauma to the soft tissue of the shoulder, less post-surgical pain and faster recovery times. There are two types of surgical repair for shoulder instability, the Bankart repair and the capsular shift.
This surgery is usually performed when the joint has suffered a traumatic injury in the past. In the Bankart repair, 3-4 small incisions of a quarter-inch or so are made on different points of the shoulder, to allow the arthroscope to be moved to different locations. A tube is inserted and the joint is irrigated with saline fluid, which washes away blood and debris during the surgery. Then any damaged tissue or bone spurs are removed and vacuumed out of the joint. Finally, the ligaments that stabilize the joint are reattached to the bone around the socket of the joint and the incisions are closed.
In some cases of shoulder instability, the joint capsule is simply too large. In these situations, the joint capsule needs to be made tighter, a surgery which is called a capsular shift. This is a relatively simple surgery in which the orthopaedic surgeon pulls up a flap of the connective tissue of the joint capsule and connects it to itself—similar to a tailor making a tuck in loose fabric. Once the proper amount of tightness is achieved, the “tuck” is sutured to hold it in position, and it heals together, creating a smaller, tighter joint capsule that is more stable.
If you are experiencing any symptoms of shoulder instability, you don’t have to suffer in silence. Contact our orthopaedic practice in NYC by calling (212) 628-9600 or by filling out our convenient form to schedule your consultation today.