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Shoulder Instability: Common Signs and Effective Treatment

As your most mobile and flexible joint, your shoulder is also susceptible to injury, dislocation, and instability. An unstable shoulder can cause pain and limits your ability to play at your best. And with severe shoulder instability, you may not even be able to play at all.

David Lintner, MD — a sports medicine specialist at Houston Methodist Orthopedics & Sports Medicine — treats unstable shoulders at his Houston and Baytown, Texas, sports medicine clinics. The following are signs and symptoms of shoulder instability, as well as effective treatments.

Signs and symptoms of shoulder instability

The shoulder is a ball-and-socket joint that can move freely in many directions. Your shoulder is unstable if the head of your humerus (i.e., the “ball” portion of your upper arm bone) slips or is forced out of the socket portion of your shoulder joint. 

Placing the shoulder ball back in its socket can be a painful procedure. And, after it’s back in its socket, it’s liable to slip out again. 

Once the tissues that keep your shoulder stable — a collection of ligaments, tendons, and muscles known as the rotator cuff — are damaged, they’re less able to keep your shoulder in place. Signs and symptoms of shoulder instability include:

Shoulder instability is often caused by an acute injury to the ligaments or labrum, such as by throwing too hard, falling, or being hit in the shoulder. However, you may also develop shoulder instability gradually through the wear-and-tear that comes with overuse. Swimmers, pitchers, and tennis players are prone to shoulder instability.

Diagnosing shoulder instability

The rotator cuff is composed of four muscles and tendons that surround the ball/socket. The rotator cuff supports/reinforces the ligaments and the labrum. If the ligaments or labrum have been damaged and the rotator cuff is unable to sufficiently compensate your shoulder will feel unstable or too loose. In addition to thoroughly examining your shoulder and evaluating its range of motion, strength, and stability, Dr. Lintner conducts imaging studies to help him pinpoint each source of damage and pain.

He also evaluates the type and degree of shoulder instability. For instance, if you’re extremely flexible, you might have multidirectional instability, which means your shoulder could slip out of its socket in the front, back, or bottom of your shoulder.

Nonsurgical treatments for shoulder instability

Generally, Dr. Lintner recommends nonsurgical treatments as a first-line therapy for any injury. However, you may need to work on your shoulder for weeks to months to evaluate the effects of such a course. Nonsurgical treatments include:

Your physical therapist may also evaluate how you use your shoulder to see if you can improve your movement efficiency. Faulty technique may have caused excess damage to your ligaments/labrum or to your rotator cuff, which led to instability.

Surgical repair for shoulder instability

If your pain and instability don’t improve with non-invasive therapies, Dr. Lintner may recommend minimally invasive surgery. He’s an expert in shoulder arthroscopy and does hundreds annually, using small incisions and tiny instruments to repair torn labrum or stretched ligaments, or torn rotator cuff tendons. This is an outpatient procedure, so you recover at home!

Arthroscopy creates less trauma than traditional open surgery. You bleed less, have a reduced risk for infection, and should have minimal scarring once the operative site has healed.

While you’re recovering from your arthroscopic treatment, Dr. Lintner recommends physical therapy. Strengthening and stretching your muscles, ligaments, and tendons with targeted exercise helps you heal faster. It also helps avoid another dislocation in the future.

Facts to remember:

- If your shoulder slips or dislocates once, it is more likely to happen again.

- Each time your shoulder slips or dislocates, additional damage to the ligaments and joint surfaces happens to the joint.

- The risk of arthritis increases with each instability episode.

- The outcome of labrum repair surgery is better if there have been fewer episodes.

Don’t ignore an unstable shoulder or give up your game. Schedule a consultation at our office nearest you today in Houston or Baytown, Texas. 

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