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What is a Shoulder Instability/Dislocation?

Shoulder instability refers to the inability of the ‘ball’ aspect of the arm bone to stay centred within the supporting shoulder blade during more dynamic movements or in severe cases, just raising an arm. This could be the result of ligamentous laxity whereby an individual has genetically more lax ligaments thus lacking in joint instability or the by-product of a traumatic dislocation.

How do I know if I have an unstable shoulder or a dislocation?

Signs and symptoms of a shoulder or a dislocation may include:

  • An obvious deformity in the shoulder resulting in pain after trauma
  • Pain and swelling after a traumatic incident
  • Audible pop sound
  • Feelings of the shoulder being loose
  • Sensation of the arm giving way or slipping away
  • Repeated shoulder dislocations
  • Weakness in arm following a dislocation

How is an unstable shoulder or a shoulder dislocation diagnosed and managed?

It is usually diagnosed through a physical examination carried out by a Doctor or Physiotherapist. Your Doctor would also recommend an MRI scan can help to determine the extent of injury to the shoulder ligaments and to determine the need for a surgical intervention. In the cases of traumatic dislocations in a young individual who wants to return to sport, a stabilisation surgery is usually recommended.

How can Physiotherapy help?

In the case of a conservatively managed unstable shoulder, the Physiotherapist will carry out an assessment of your shoulder region to determine what movements feel the most unstable. This would include an assessment of the range of movements in your shoulder, the mobility of the shoulder joint and the flexibility of the surrounding muscles. The role of Physiotherapy is to assist with strengthening the muscles surrounding the shoulder so that it is strong enough to hold the shoulder in place during daily tasks.

Treatment may include but is not limited to:

  • Advise and education pertaining to your condition
  • Soft tissue therapy
  • Heat therapy
  • Electrotherapy
  • Dry needling
  • Shockwave therapy
  • Taping to support the shoulder
  • Personalised home exercise program

Will shoulder instability go away on its own?

This would depend on the extent of the injury sustained and how unstable the shoulder is. In more severe traumatic cases, a stabilisation procedure is usually warranted. However, in cases where the injury is mild then the instability will normally resolve on its own. Despite its ability to self-resolve, the muscles surrounding the shoulder would have been affected. A Physiotherapist can help with identifying which muscles need to be strengthened in order to prevent future dislocations.

What activities should I avoid if I have shoulder instability?

If your shoulder has just suffered a recent dislocation, it might be placed in an arm sling for a few weeks to ensure it is in the best possible position for healing to occur. In which case, the movements which should generally be avoided are overhead movements or the ‘stop’ sign position.

If your shoulder dislocations are recurrent and are aggravated by certain movements, a consultation with an Orthopaedic specialist and Physiotherapist is advised to determine what is the best possible solution.