- Anterior Shoulder Instability
- Posterior Shoulder Instability
- Multidirectional Instability Of the Shoulder
- Shoulder Labral Tear with Instability
What is Shoulder Instability?
Shoulder instability is a chronic condition that causes frequent dislocation of the shoulder joint.
Causes of Shoulder Instability
A dislocation occurs when the end of the humerus (ball portion) partially or completely dislocates from the glenoid (socket portion) of the shoulder. A partial dislocation is referred to as a subluxation whereas a complete separation is referred to as a dislocation.
Risk Factors of Shoulder Instability
The risk factors that increase the chances of developing shoulder instability include:
- Injury or trauma to the shoulder
- Falling on an outstretched hand
- Repetitive overhead sports such as baseball, swimming, volleyball or weightlifting
- Loose shoulder ligaments or an enlarged capsule
Symptoms of Shoulder Instability
The common symptoms of shoulder instability include pain with certain movements of the shoulder, popping or grinding sound that may be heard or felt, swelling and bruising of the shoulder seen immediately following subluxation or dislocation.
Visible deformity and loss of function of the shoulder occur after subluxation or sensation changes such as numbness. Partial paralysis can occur below the dislocation because of pressure on nerves and blood vessels.
Treatment Options for Shoulder Instability
Conservative Treatments for Shoulder Instability
The goal of conservative treatment for shoulder instability is to restore stability, strength and a full range of motion. Conservative treatment measures may include the following: Closed reduction: Following a dislocation, your surgeon can often manipulate the shoulder joint, usually under anesthesia, realigning it into proper position. Surgery may be necessary to restore normal function depending on your condition.
Medications: Over-the-counter pain medications and NSAIDs can help reduce the pain and swelling. Steroidal injections may also be administered to decrease swelling. Rest: Rest the injured shoulder and avoid activities that require overhead motion. A sling may be worn for 2 weeks to facilitate healing. Ice: Ice packs should be applied to the affected area for 20 minutes every hour.
Surgery for Shoulder Instability
When conservative treatment options fail to relieve shoulder instability, your surgeon may recommend shoulder stabilization surgery. Shoulder stabilization surgery is performed to improve the stability and function of the shoulder joint and prevent recurrent dislocations. It can be performed arthroscopically, depending on your condition, with much smaller incisions.
Arthroscopy is a surgical procedure in which an arthroscope, a small flexible tube with a light and video camera at the end, is inserted into a joint to evaluate and treat the condition. The benefits of arthroscopy compared to the alternative, open shoulder surgery, are smaller incisions, minimal soft tissue trauma, less pain leading to faster recovery.
Anatomy of the Shoulder
The shoulder joint is a ball and socket joint. A ball at the top of the upper arm bone (humerus) fits neatly into a socket, called the glenoid, which is part of the shoulder blade (scapula). The glenoid is surrounded by a ring of fibrous cartilage called the labrum for stabilization of the shoulder joint.
What is Shoulder Dislocation?
Sports that involve overhead movements and repeated use of the shoulder at your workplace may lead to sliding of the upper arm bone from the glenoid. The dislocation might be a partial dislocation (subluxation) or a complete dislocation causing pain and shoulder joint instability. The shoulder joint often dislocates in the forward direction (anterior instability), and sometimes in the backward or downward direction.
Symptoms of Shoulder Dislocation
The most common symptoms of shoulder dislocation include pain and shoulder joint instability. Other symptoms such as swelling, numbness and bruising may also occur. At times, it may cause tears in the ligaments or tendons of the shoulder and nerve damage.
Diagnosis of Shoulder Dislocation
Your doctor will examine your shoulder and may order an X-ray to confirm the diagnosis.
Treatments for Shoulder Dislocation
The condition is treated by a process called closed reduction, which involves placing the ball of the upper arm back into the socket. Following this, the shoulder will be immobilized using a sling for several weeks. Ice may be applied over the area 3-4 times a day. Rehabilitation exercises may be started to restore range of motion, once the pain and swelling decrease.