What Treatment for Shoulder Instability Involves

 

Closeup of man holding his injured painful shoulder.

The shoulder has a wider range of motion than any other joint in the human body. While this mobility allows you to perform many everyday activities and excel at sports that involve throwing and overhead movements, the price of this extreme range of motion is less stability. In other words, with more mobility comes a greater susceptibility to injury.

 

Here’s an overview from the orthopedic shoulder specialists at NY Orthopedics on what you need to know about shoulder instability, its symptoms, causes and your treatment options.

 

What is shoulder instability?

Shoulder instability is a condition affecting the glenohumeral joint—the point where the arm joins the body. It’s a complex joint formed by the intersection of the clavicle (collar bone), scapula (shoulder blade) and head of the humerus (the upper arm bone). Shoulder instability happens when the connective tissue holding the upper arm bone in place fails to do its job properly and lets the bone move out of place.

 

Like the hip, the glenohumeral joint is a ball-and-socket joint, with the head of the humerus (the ball) fitting into the socket formed by the clavicle and scapula. This socket, however, is much shallower than that of the hip and the glenohumeral joint has much less bony support. Instead, it relies on a number of ligaments and tendons for stability. When one or more of these connective tissues is damaged, the head of the humerus can start to move too freely and slip either partially (subluxation) or completely (dislocation) out of the socket. This is called shoulder instability.

 

What causes shoulder instability?

Shoulder instability may result from direct trauma, such as a fall onto an outstretched arm, resulting in a dislocation, or due to other injuries that tear or stretch the ligaments in the shoulder. If you experience a shoulder dislocation once (particularly before the age of 30) you are much more prone to shoulder instability and repeat dislocation(s) later on.

 

The condition can also be caused by a congenital problem; some people simply have more lax connective tissues than most. Those who are “double-jointed” are particularly at risk. Most often, however, shoulder instability is the result of repetitive strain on the shoulder joint and chronic overuse. Some activities such as pitching a ball can subject the joint to tremendous amounts of force. Over time, repetitive force will stretch and weaken the shoulder’s ligaments and tendons, leading to instability.

 

What are the symptoms of shoulder instability?

One of the hallmark symptoms of shoulder instability is pain when moving the joint through its full range of motion.

 

Other symptoms of shoulder instability may include:

  • A clicking or popping feeling when you move the joint
  • Pain, weakness or numbness during activities that necessitate raising your arm
  • Repeated subluxations (partial dislocations where the joint slips partially, but not completely, out of place)
  • Tenderness to the touch

 

In some cases, you may have no symptoms at all until your shoulder spontaneously subluxates, but this is not common.

 

What does treatment for shoulder instability involve?

There is no one-size-fits-all treatment for shoulder instability, but the best time to seek medical evaluation is when you first notice symptoms, as waiting to seek treatment for shoulder pain associated with instability could cause further damage to shoulder joint cartilage or the rotator cuff tendons.

 

Conservative measures are usually the first line of treatment, and the fellowship-trained physicians at our Hand, Wrist, Elbow and Shoulder Center and our Physiatry Center specialize in non-surgical solutions. One common conservative treatment option is physician-directed physical therapy and a home exercise program. However, if your condition doesn’t respond to conservative treatments, surgery may be an option.

 

There are two types of surgery commonly used for the treatment of shoulder instability.

  • Capsular shift surgery is done when the joint capsule—the connective tissue surrounding and enclosing the joint—is simply too large. In this case, the surgeon makes a sort of “tuck” in the connective tissue, like a tailor taking in the seams of a suit. The tuck is sutured in position and heals together, making a tighter joint capsule that holds the joint stable.
  • Bankart repair surgery is usually done when the joint has suffered trauma in the past and has damage to the connective tissue. The surgery repairs the ligaments that stabilize the shoulder. The labrum or soft cartilage where the shoulder ligaments attach at the rim of the shoulder socket are often repaired in a minimally invasive fashion using sutures and small bio-absorbable anchors.

 

Both capsular shift and Bankart repair surgeries can be done arthroscopically, meaning they can be performed through small incisions with the aid of a camera inserted into the joint. This means less soft tissue trauma, less pain after surgery, and for many patients, faster recovery times. To learn more about what these two procedures involve, head over to our Video Learning Center to watch videos that explain them in detail.

 

Seeking treatment for shoulder instability in NY?

If you’re suffering from any symptoms of shoulder instability, NY Orthopedics is here to help. We’re dedicated to relieving your discomfort, restoring function and mobility, and most of all, improving your quality of life. Our team of fellowship-trained orthopedic specialists will work with you to tailor a treatment plan to fit your individual needs.

 

Shoulder pain doesn’t have to be a part of your life. Schedule your appointment online today, or contact one of our six convenient locations to access the high quality treatment for shoulder instability that you deserve.

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Dr. Jose Rodriguez is no longer practicing at New York Orthopedics as of March 31, 2017. For a full list of our doctors, please visit this page.