The shoulder is the joint in the human body with the greatest range of motion. It is made up of three main bones– the shoulder blade, the collarbone, and the upper arm bone. Along with these three bones are a variety of ligaments and tissues to keep the joint secure. The great mobility and complexity of the joint also leads to less support, which can lead to chronic shoulder instability.
When the head of the arm bone is unnaturally popped out of the shoulder socket as a result of trauma or overuse, a dislocation of the shoulder occurs. A complete dislocation means that the ball on the head of the arm bone came completely out of the socket. Partial dislocation is called subluxation, and in this case, the ball only comes partially out of the socket.
Once the shoulder has been dislocated once, there is the possibility that it will pop out of place repeatedly because the ligaments and tendons in the area have become loose. When the tissues in the shoulder can no longer keep the arm in the shoulder socket, is called shoulder instability. This is the most common cause of the condition.
However, some people who experience shoulder instability have never had a dislocation. Some patients have naturally looser ligaments in the joint, while others have conditions caused by repetitive overhead motion due to athletics or occupation. In these cases, the tissues within the shoulder joint are stretched out over time. This weakens the shoulder.
Sometimes, this condition can occur without history of injury. In these patients, the ball can slip in any variety of directions. This occurs in those with naturally loose ligaments, or people who may be referred to as double-jointed.
Symptoms and Diagnosis
A doctor specializing in treatment of the upper extremities, such as Dr. Leah Urbanosky of Hinsdale Orthopaedics, will do a series of physical tests to determine the stability of the shoulder. An x-ray may be taken to see if there are any bone injuries that may contribute to the condition, while an MRI will capture images of the ligaments and tendons. Some symptoms of shoulder instability:
Report of these symptoms, in combination with a physical examination from a physician, will help determine the nature of the condition, as well as proper treatment.
For a condition such as shoulder instability, patience is necessary in order to achieve the best possible results. Many times, nonsurgical treatment options may not work for a long period of time. Initially, a doctor will prescribe small modifications in lifestyle habits in order to determine the amount of pain affected by daily life activities. This may be in combination with anti-inflammatory medication and physical therapy.
Though there are non-operative options to remedy the pain caused by shoulder instability, surgery is a common solution. There are a few options for the procedure, so it requires extensive consultation with a physician such as Dr. Urbanosky.
A minimally invasive surgery option is an arthroscopy, where a small camera is used along with multiple small incisions. This procedure is often outpatient and repairs the soft tissues within the shoulder. A similar repair surgery can be done with an open procedure, which requires a larger incision.
Post-surgery, the shoulder may be put in a sling in order to allow it to heal. Small rehabilitation exercises will be added to strengthen the shoulder post-surgery.
If you think that you may have shoulder instability, contact Dr. Leah Urbanosky for a consultation: (815) 462-3474.
Labral Tears (including SLAP tear)
Total Shoulder Replacement
Total Shoulder Replacement Animations
Advantage TSR (shown top)
Global TRS (shown bottom)