Female tennisplayer serving.


The shoulder is the most mobile joint in the body. It allows one to lift the arm, rotate it, and reach up overhead. It is able to turn in many directions. This greater range of motion, however, results in less stability.

The should­er is made up of three bones: hume­rus (upper arm bone), sca­pu­la (should­er bla­de), and cla­vic­le (col­lar­bo­ne). Should­er dis­lo­ca­ti­ons can be par­ti­al, with the ball of the upper arm coming just par­ti­al­ly out of the socket. This is cal­led a sub­lu­xa­ti­on. A com­ple­te dis­lo­ca­ti­on means the ball comes all the way out of the socket.

How do shoulder dislocations happen?

Should­er insta­bi­li­ty occurs when the head of hume­rus (the upper arm bone) is forced out of the should­er socket. This usual­ly occurs as a result of a sud­den trau­ma­tic injury. 

Once a should­er has dis­lo­ca­ted, it is vul­nerable to repeat epi­so­des. When the should­er is loo­se and slips out of place repea­ted­ly, it is cal­led chro­nic should­er instability.

What are the symptoms of shoulder instability?

Com­mon sym­ptoms of chro­nic should­er insta­bi­li­ty include:

  • Pain cau­sed by should­er injury 
  • Repea­ted should­er dislocations 
  • Repea­ted ins­tances of the should­er giving out 
  • A per­sis­tent sen­sa­ti­on of the should­er fee­ling loo­se, slip­ping in and out of the joint, or just “han­ging there”

How is shoulder instability diagnosed?

The­re are spe­ci­fic tests that help assess insta­bi­li­ty in the should­er, inclu­ding gene­ral loo­sen­ess in liga­ments. A doc­tor may order ima­ging tests, inclu­ding X‑rays, CT scan, or MRI to help con­firm a dia­gno­sis and iden­ti­fy any other problems.

How is shoulder instability treated and how long is recovery?

Chro­nic should­er insta­bi­li­ty is often first trea­ted with non­sur­gi­cal opti­ons. If the­se opti­ons do not reli­e­ve the pain and insta­bi­li­ty, sur­gery may be needed.

Nonsurgical Treatment

It often takes seve­ral months of non­sur­gi­cal tre­at­ment befo­re an assess­ment of suc­cess can be made. Non­sur­gi­cal tre­at­ment typi­cal­ly includes:

  • Acti­vi­ty modification 
  • Non-ste­ro­idal anti-inflamm­a­to­ry medication 
  • Phy­si­cal therapy
Dis­lo­ca­ted should­er and should­er realigned

Surgical Treatment

Sur­gery is often neces­sa­ry to repair torn or stret­ched liga­ments so that they are bet­ter able to hold the should­er joint in place.

  • Bank­hart lesi­ons (tearing of the front labrum from the socket) can be sur­gi­cal­ly repai­red by using suture anchors to reat­tach the liga­ment to the bone. 
  • Arthroscopy—Soft tis­sues in the should­er can be repai­red using tiny instru­ments and small incis­i­ons. This is a same­day or out­pa­ti­ent pro­ce­du­re. Arthro­sco­py is mini­mal­ly inva­si­ve sur­gery. A sur­ge­on will look insi­de the should­er with a tiny came­ra and per­form the sur­gery with spe­cial instruments. 
  • Open Surgery—Some pati­ents may need an open sur­gi­cal pro­ce­du­re. This invol­ves making a lar­ger incis­i­on over the should­er and per­forming the repair under direct visualization.


After sur­gery, the should­er may be immo­bi­li­zed tem­po­r­a­ri­ly with a sling. When the sling is remo­ved, exer­ci­s­es to reha­bi­li­ta­te the liga­ments will be star­ted. The­se will impro­ve the ran­ge of moti­on in the should­er and pre­vent scar­ri­ng as the liga­ments heal. Exer­ci­s­es to streng­then a should­er will gra­du­al­ly be added to a reha­bi­li­ta­ti­on plan.



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