Shoulder Instability

What is shoulder instability?

Shoulder instability is a chronic condition that occurs when the shoulder joint repeatedly slips out of place. This happens when the end of the upper arm bone (humerus) partially or fully dislocates from the shoulder socket (glenoid). A partial dislocation is called a subluxation, while a full dislocation involves a complete separation of the joint.

At Novant Health, we understand how frustrating and limiting shoulder instability can be. Our specialists take the time to explain your condition, ease your concerns and find a treatment plan that supports healing, restores function and allows you to return to the activities you love.

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What causes shoulder instability?

The shoulder is the most mobile joint in the body, allowing your arm to move in a wide range of directions. Its stability depends on a combination of bones, ligaments, tendons and muscles. When these supporting structures are weakened or damaged, the shoulder can become unstable, making dislocations more likely and increasing the risk of pain and injury over time.

Overview

Symptoms

You may be experiencing shoulder instability if you notice:

Pain with certain shoulder movements
Popping, grinding or clicking sensations
Swelling or bruising immediately after a subluxation or dislocation
Visible deformity of the shoulder after dislocation
Loss of function or difficulty moving your arm
Numbness or partial paralysis below the shoulder caused by pressure on nerves or blood vessels

Symptoms may range from occasional discomfort to frequent dislocations that interfere with daily activities or athletic performance.

Causes

Shoulder instability can result from a variety of causes. Common factors include:

Injury or trauma, such as a fall or collision
Falling on an outstretched hand, which can force the joint out of place
Repetitive overhead sports, including baseball, swimming, volleyball or weightlifting
Loose shoulder ligaments or an enlarged capsule that allows the joint to move too freely

Understanding the underlying cause helps our specialists design the most effective treatment plan for your shoulder.

Diagnosis

Our orthopedic specialists perform a comprehensive evaluation that may include:

A detailed medical history and physical exam
Assessment of shoulder strength, range of motion and stability
Imaging studies such as X-rays or MRI to examine bones, ligaments and soft tissues

This thorough approach ensures an accurate diagnosis and a clear path forward for treatment.

Why treatment matters

Nonoperative treatment

Many patients benefit from conservative treatment before considering surgery. The goal is to restore shoulder stability, strength and full range of motion. Options may include:

Closed reduction: If the shoulder dislocates, your surgeon can often manipulate it back into place, usually under anesthesia.
Medications: Over-the-counter pain relievers or NSAIDs help manage pain and swelling. Steroid injections may be used for inflammation.
Rest and immobilization: Avoid activities that stress the shoulder and possibly wear a sling for about two weeks.
Ice therapy: Applying ice packs for 20 minutes each hour can reduce swelling and discomfort.
Physical therapy: Strengthening and stability exercises help prevent future dislocations and restore normal function.

Operative treatment

If conservative measures do not improve stability, shoulder stabilization surgery may be recommended. Surgery is designed to restore proper alignment, improve joint stability and reduce the risk of recurrent dislocations.

Arthroscopic surgery: this minimally invasive approach uses a small camera and specialized instruments to repair damaged ligaments and tendons
Benefits: smaller incisions, less soft tissue trauma, reduced pain and faster recovery compared to traditional open surgery

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Take the next step

Our board-certified specialists are here to help you heal. They can often diagnose the problem in one visit and get you started with a personalized treatment plan. We offer a wide variety of treatment options.