Shoulder Instability and Dislocations

What is shoulder instability?

The shoulder is the most unstable and commonly dislocated joint that we have. There are many forms of instability and they all need to be treated differently.

What are the symptoms?

In some cases, an unstable shoulder is quite obvious but in others it is not. The common symptoms of shoulder instability include pain with certain movements of the shoulder; popping or grinding sound may be heard or felt, swelling and bruising of the shoulder may be seen immediately following subluxation or dislocation. Visible deformity and loss of function of the shoulder occurs after subluxation or sensation changes such as numbness or even partial paralysis can occur below the dislocation as a result of pressure on nerves and blood vessels

What are the types of shoulder instability?

We group shoulder instability based on the direction of instability. These are usually anterior, posterior, inferior or multi-directional. We also group them based on their cause such as high-end trauma, low impact, loose ligaments or an abnormally shallow socket. All of these factors will influence the best way to manage it.

Do I need surgery for shoulder instability?

Surgery can be very effective for certain types of shoulder instability and very ineffective for others. We rely on research and experience to decide which category an individual fits into. For example there is strong evidence that an 18 year old male without loose joints who suffers a dislocation from forceful trauma and intends to play collision contact sport in the future has almost a 100% chance of a repeat dislocation without surgery. People that have hypermobility or joint laxity who suffer a low-impact dislocation and not much structural damage in the process can do very well with non-surgical management.

Should I see a Sport and Exercise Physician for shoulder instability?

A Sports Physician has the knowledge and experience to help you understand if your shoulder instability is likely to require surgery or conservative management. They can check for associated injuries to your cartilage, bone, nerve and rotator cuff which may also require management. A sports physician can also help to treat and prevent post-traumatic capsulitis which can happen after a shoulder injury. They will also give you expert advice on the safest way to return to your sports and activities.

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