What is Shoulder Instability?

The glenohumeral joint is one of four joints in the shoulder complex, formed by the head of the humerus (upper arm bone) and the glenoid portion of the scapula (shoulder blade). This ball-and-socket joint enables movement in multiple directions, but its large range of motion makes it susceptible to shoulder dislocations and instability issues. If the soft tissue restraints within the shoulder become damaged from trauma, a shoulder separation can occur. In this condition, the tendons and ligaments may tear or stretch from their attachment site, leading to instability and weakness in the shoulder.

Shoulder instability occurs when the soft tissues responsible for joint stability are weakened, resulting in recurrent shoulder dislocations. Athletes, particularly those performing repetitive overhead movements such as in baseball, swimming, and volleyball, are at greater risk of developing shoulder instability.

Dr. Khaleel, Senior Consultant Arthroscopic Shoulder and Sports Surgeon at Kims Alshifa, Perintalmanna, Kerala, India, has extensive knowledge and experience in treating patients with shoulder instability.

What are the Symptoms of Shoulder Instability?

A common complaint of shoulder instability is pain following an injury, which often worsens with activities like reaching behind the back or throwing a ball.

• Decreased range of motion in the affected shoulder or arm
• Swelling and/or bruising
• A sensation of the shoulder joint giving out
• Recurrent shoulder dislocations

How is Shoulder Instability Diagnosed?

A comprehensive medical history will be obtained, including details of the initial injury and any history of recurrent shoulder dislocations. Dr. Khaleel will perform a thorough physical examination to evaluate for chronic shoulder instability. Diagnostic imaging may be recommended depending on the injury severity.

• X-rays: Can show any damage to the bones of the shoulder joint.
• MRI (Magnetic Resonance Imaging): Can confirm a shoulder instability diagnosis and assess soft-tissue damage.
• Arthrogram: May be recommended to evaluate additional structures in the shoulder joint.

What is the Treatment for Shoulder Instability?

If a shoulder dislocation is suspected, immediate medical attention from an orthopedic shoulder specialist is strongly advised.

Non-Surgical Treatment:

If a shoulder dislocation is confirmed, a medical professional will manually manipulate the humeral head back into the glenoid socket. This reduction technique should only be performed by an experienced medical provider. If the shoulder joint is successfully reduced, pain should immediately improve.

Following a successful reduction, Dr. Khaleel will immobilize the shoulder with a sling or other support device to allow the ligaments to heal. A combination of rest, ice, and non-steroidal anti-inflammatory medications (NSAIDs) can help manage pain and inflammation. If pain persists, a corticosteroid injection may be recommended.

Surgical Treatment:

In cases of severe shoulder instability or an unsuccessful joint reduction, Dr. Khaleel may recommend arthroscopic shoulder surgery. This minimally invasive procedure uses a small camera (arthroscope) and specialized instruments to examine and repair damaged soft tissues in the shoulder. Arthroscopic surgery is highly effective in correcting shoulder instability and reducing recovery time.