Your shoulder is a highly mobile ball-and-socket joint that allows your arms to raise, lower, and twist. That mobility is due to a shallow socket portion of the joint, which offers a high range of motion but minimal security.
It doesn’t take much to stretch or tear the tendons, ligaments, and muscles holding your shoulder in place. Furthermore, it doesn’t take much to knock the ball portion of our shoulder joint out of its socket.
As a result, shoulder instability can be a chronic problem in athletes, especially throwing athletes, who exert tremendous forces on their shoulders. However, even football players can experience shoulder instability due to collisions as well as throwing forces.
Sports specialist David Lintner, MD, diagnoses and treats sports injuries in athletes and nonathletes of all ages. At Houston Methodist Orthopedics & Sports Medicine in Houston, Texas, he recommends a shoulder evaluation at the first sign of dysfunction.
Do you have shoulder instability? The following are the signs you might need to tend to your most mobile joint.
Injury or overuse is usually behind shoulder instability. However, that’s not always the case. For example, you could have been born with unusually loose ligaments in your shoulder. This type of instability is called hyperlaxity.
You might also have an unusually unstable shoulder if you’re double-jointed. With this condition, your shoulder may feel loose or weak in multiple directions.
In most other cases, shoulder instability is caused by a fall, blow, or sudden movement (e.g., throwing or pitching) that either wholly or partially dislocates the ball part of your shoulder joint from the socket.
Repetitive stress, such as overusing your shoulder via pitching or another movement you often make, can lead to shoulder instability. High intensity overhand throwing can create instability, and if your shoulder is already a little loose can create pain during and after throwing.
Shoulder instability doesn’t just manifest as a loose or unstable shoulder. When your joint slips out of place, it can irritate nearby nerves and cause referred pain.
You may notice that your arm is numb. You could have tingling sensations in your arm or fingers. Of course, these could be the symptoms of another problem, which is why it’s always helpful to get a diagnosis.
A classic sign of instability is a shoulder joint that clicks, catches, or pops when you move your arm. Many times clicking/popping is benign, but occasionally that’s the sound and sensation of your upper arm joint moving in and out of its socket.
Over time, repeated slipping of the ball on the socket can wear away your cartilage and other protective tissues. You may develop arthritis in your shoulder that can limit motion and strength.
If you have trouble raising your arm over your head, something’s wrong in your shoulder joint. You may have an unstable shoulder or a rotator cuff problem.
When you have an unstable shoulder, it’s easy for it to become dislocated. A simple arm movement may throw the ball portion of your joint away from the center of the socket.
If your shoulder is completely out of its socket, that’s a dislocation. If it’s moved to the wrong part of its socket or partially displaced, it’s considered a subluxation. This can feel like a “dead arm” or a feeling of giving way.
If you have symptoms of shoulder instability, you might first try to treat it yourself, especially if it’s a result of an acute incident, such as a collision or fall. Remedies to try include:
However, if your pain is acute or your instability limits your ability to use your arm, see our team immediately. If you’re a professional, amateur, or youth athlete, any type of joint pain should be evaluated by a sports specialist so you can get the treatment you need to heal and rehabilitate.
If you have repeated (two more) dislocations or instability/subluxation events the odds are very high that you will continue to do so even with PT. You may need arthroscopic surgery to tighten loose ligaments and repair your labrum. Tighter ligaments do a better job of holding your shoulder in its socket.
To really know what’s going on in your shoulder and how to resolve it, we need a physical exam and imaging studies that let us evaluate the health of the structures of your shoulder.
Do you have an unstable or painful shoulder or arm? Contact Dr. Lintner and our team today for a shoulder evaluation and shoulder instability treatment by phone or online.
If you don’t live in the Houston area, Dr. Lintner is happy to provide a second opinion if you forward him imaging studies of your shoulder joint.
