Shoulder Instability

Shoulder Instability

The human shoulder is a highly flexible joint that allows us to perform various complex movements. This enhanced mobility also makes it prone to instability issues. Shoulder instability occurs when the upper arm bone slips out of its socket in the shoulder blade, leading to pain, discomfort, and limited movement. If left untreated, this condition can cause painful shoulder dislocations and further restrict your ability to move. At Florida Medical Clinic Orlando Health, our orthopedic specialists are dedicated to diagnosing and treating shoulder instability. We work to restore stability, reduce pain, and improve your range of motion, helping you get back to your daily activities without worrying about dislocations.

Anatomy of the Shoulder Joint

The shoulder is a ball-and-socket joint where the rounded head of the upper arm bone fits into a shallow socket in the shoulder blade. This design allows for a wide range of motion, enabling complex movements. However, the trade-off is reduced stability. The joint relies on surrounding soft tissues, including muscles, tendons, and ligaments, to provide support and keep the shoulder stable. The bony structures themselves are relatively small and shallow, making the shoulder highly mobile but also more prone to instability.

Causes of Shoulder Instability

Shoulder instability is caused mainly by three main factors:

Traumatic Injury

A common trigger for shoulder instability is a sudden, traumatic injury. This can be a fall, impact, or sudden movement. These events can force the upper arm bone out of its socket and may damage nearby tissues. It could also weaken the shoulder joint and make it unstable in the future.

Repetitive Overuse

Repetitive overhead motions in sports like swimming and tennis can cause shoulder instability over time. Constant stress on the shoulder joint can weaken supporting tissues, increasing the risk of the humeral head slipping out of place.

Genetic Predisposition

Some people are genetically prone to shoulder instability. Their ligaments are naturally loose, even without injury or overuse.

Symptoms of Shoulder Instability

Although the following symptoms do not guarantee shoulder instability, common signs can include:

• The feeling of the shoulder “slipping” or “giving way”
• Recurrent shoulder dislocations or partial dislocations
• Persistent pain, especially during overhead activities
• Decreased range of motion
• Weakness when moving the arm
• Swelling or tenderness around the joint

Diagnosing Shoulder Instability

When evaluating a patient for shoulder instability, physicians usually follow a multi-step approach. It may include:

Physical Examination

Physicians assess range of motion, strength, and stability. They use tests like the apprehension test to check shoulder laxity and instability direction (anterior, posterior, or multidirectional).

Imaging Tests

X-rays, MRIs, or CT scans can reveal underlying structural issues.

Patient History

Reviewing past injuries, instability episodes, and lifestyle helps pinpoint causes and guide treatment.

Nonsurgical Treatment Options

For many with shoulder instability, the first treatment will be nonsurgical. It will aim to restore stability and function to the shoulder.

• Activity Modification: Patients may need to avoid activities that worsen shoulder instability. This includes overhead reaching and high-impact sports. These modifications help reduce injury risk and allow soft tissues to heal.
• Physical Therapy: A key treatment is a customized physical therapy program. It focuses on strengthening shoulder muscles, improving flexibility and range of motion, and enhancing neuromuscular control and proprioception.
• Medication: Over-the-counter anti-inflammatory drugs may help with pain and swelling. In some cases, corticosteroid injections can reduce inflammation and provide temporary relief.
• Bracing or Immobilization: A sling or brace may be recommended after a shoulder dislocation or for severe instability to limit movement and allow healing.

Surgical Treatment Options

If nonsurgical interventions fail to address the shoulder instability adequately or if the condition is deemed severe, surgical treatment may be recommended. The specific surgical approach will depend on the underlying cause and the extent of the damage to the shoulder joint.

• Arthroscopic Stabilization: A minimally invasive procedure to repair torn or damaged soft tissues using small incisions and a tiny camera.
• Open Stabilization: A larger incision allows direct access to repair damaged structures for complex cases.
• Bone Block Procedures: These address bony defects preventing proper stabilization, often using the patient’s bone to create a “block.”

No matter the surgical approach, post-operative rehab is vital. It includes physical therapy. It is key to regaining strength, mobility, and stability in the shoulder.

Recovering from Shoulder Instability

Recovery from shoulder instability treatment varies based on severity, treatment type, and the patient’s health. General guidelines include:

• Nonsurgical treatment: Gradual improvement over weeks to months with physical therapy and activity changes.
• Arthroscopic stabilization: Faster recovery, with normal activities resuming in 3-6 months.
• Open stabilization: Longer recovery, often 6 months to a year, before returning to pre-injury activity levels.

Patients must follow their rehab plan throughout the recovery process, including wearing a sling, performing exercises, and slowly returning to daily activities. Regular follow-up appointments with your physician will also help monitor progress and ensure a successful outcome.

Preventing Future Shoulder Instability

After experiencing an episode of shoulder instability, it’s important to focus on prevention, as the risk of it happening again is higher. Strengthening the shoulder muscles, especially the rotator cuff and scapular stabilizers, through specific exercises can significantly improve stability. It’s also important to keep the shoulder flexible. Focus on the posterior capsule and external rotators. This will reduce joint stress and prevent more instability. Avoid risky shoulder positions in sports, hobbies, or work. Regular check-ups with specialists are vital for your shoulder health, as they provide advice to prevent future issues.

Restoring Shoulder Stability

Shoulder instability can seriously affect your quality of life by limiting your movement and causing discomfort. With the proper guidance and dedication, you can restore confidence in your shoulder and get back to enjoying your favorite activities. At Florida Medical Clinic Orlando Health, we provide thorough care, including personalized treatment plans and preventive strategies to address shoulder instability. Our team of specialists is committed to helping you regain stability and return to the activities you love. Contact us today to schedule your appointment and start your recovery journey.

Proudly Serving: Brandon, North Tampa, St. Petersburg, Wesley Chapel, and Zephyrhills.