The shoulder, when suffering from instability in the joint, can become excessively loosened. This regularly results in the shoulder sliding out of position, sometimes to the degree that it causes a dislocation, and often present is a continuous unpleasant feeling that the shoulder might pop out of place.
When the shoulder moves out of position due to instability, this is known as shoulder subluxation. The symptoms will not be as severe as a full dislocation, but pain and numbness can still arise. The shoulder may also feel weakened and noticeably loose, with an unusual sensation of the joint sliding in and out of place. If the instability provokes a dislocation, the pain will be severe and the shoulder joint immovable.
A more common result of shoulder instability is 'apprehension,' defined as an uncomfortable feeling that the joint is slack and may leave its socket. It may not manifest in serious pain but can be very serious, inhibiting sufferers from playing sports or partaking in other activities. This feeling can be identified by a doctor using a simple physical test.
Shoulder instability is prevalent among athletes, especially those aged below 30. Any sports activity involving repeated overhead arm movements can lead to a participant developing the condition, such as swimming, tennis and volleyball. This is due to regular overstretching of the shoulder ligaments, the likelihood of which can be increased if warm ups are frequently cut short or the shoulder muscles and surrounding structures are not sufficiently strengthened.
Approximately 80% of young people, aged below 30-35, who sustain a shoulder dislocation end up with instability in the area. In their dislocation a ligament is often torn, meaning that the shoulder supports are weakened in future and are thus prone to instability.
Sometimes shoulder instability is related simply to connective tissue problems, such as being double jointed, which can perpetually loosen many joints in the body.
See a doctor as soon as possible so that they can diagnose the specific type of instability; the treatment will vary depending on its severity. Do not participate in shoulder-heavy activities that could worsen the injury until a doctor tells you otherwise. Full dislocations will need to be reset, but this does not treat the instability itself.
Treatment commonly starts with physical therapy, incorporating stretching and strengthening exercises for the shoulder that seek to build up strength in the joint and in the surrounding muscles and ligaments. Some exercises can also help to train the shoulder to remain in a suitable position. Anti-inflammatory pain medication might be prescribed to reduce pain and any swelling.
In the event of little or no improvement following conservative methods, the doctor will be able to discuss appropriate surgical intervention. This will depend on the case, but an arthroscopic procedure to tighten the shoulder capsule, and a Bankart repair to heal a torn ligament, are both common.
Returning to Activity
Generally speaking you should not return to shoulder activity until all pain has gone and strength is significantly improved.
- acromioclavicular joint injury
- fractured clavicle
- frozen shoulder
- rotator cuff injury
- shoulder impingement
- shoulder instability
- sternoclavicular joint injuries
- subscapularis tendon tear