The shoulder joint relies on many ligaments and surrounding structures to keep the “ball and socket” stable. When the “ball,” or head of the humerus, is forced out of the socket, ligaments and surrounding tissue become stretched and the labrum can tear. Therefore, the shoulder is more prone to slipping out of place, or dislocating, after the initial episode. Some patients may have no history of injury, but their shoulder frequently feels “loose” or unstable.
Signs and symptoms of shoulder instability are: multiple dislocations, shoulder “giving out” sensation, sharp pain or “dead arm” feeling, and constant sensation of loose or weak shoulder.
A small subset of people have generalized laxity and loose ligaments throughout their bodies and can experience these symptoms as well.
After discussing history of injury and symptoms, your medical provider will perform a physical exam to better assess the type of instability your are experiencing. Often times, radiographs and shoulder MRIs or arthrograms are ordered to evaluate the tissue and labrum, which can be injured during a dislocation event.
Anti-inflammatory medications to reduce pain and inflammation, physical therapy to strengthen shoulder and scapular musculature, and activity modification to avoid movements that reproduce symptoms are initial treatment recommendations. Patients with continued symptoms may be candidates for shoulder arthroscopy surgery to tighten the stretched capsule and ligaments and repair the labrum, making the shoulder joint more stable. After surgery, a sling is worn for 4-6 weeks, and you will attend physical therapy for 3-4 months.