Shoulder Dislocation & Instability Specialist

What is shoulder dislocation and instability?

Your shoulder is a ball-and-socket joint with distinct anatomy that makes it vulnerable to dislocation and instability. The ball of your shoulder joint is the top part of your upper arm bone (humerus), and the socket (glenoid or glenoid fossa) is a shallow groove that comes off your shoulder blade (scapula) and sits flush with the ball.

Due to the glenoid's small size, sufficient direct force can dislocate the humeral head. A dislocation occurs when the head of your humerus comes completely out of the glenoid. Once this happens, your shoulder is more likely to dislocate again, a condition known as recurrent instability.

Partial dislocations (subluxations) occur when your shoulder doesn't dislocate completely, and typically reduce on their own without medical assistance. 

When the shoulder dislocates, it often tears the labrum (the cartilage lining the glenoid).  This further increases the risk of recurrent dislocations.

Labral tears may also occur as a result of wear from overuse. This injury can cause pain in the back of your shoulder with activities like weight lifting or pain in the top of your shoulder with overhead activities like throwing. The Alta Orthopaedics team diagnoses labral tears with a combination of history, physical exam, and an MRI or MR arthrogram (MRI with dye in the joint).

What are the symptoms of shoulder dislocation and instability?

The most common symptoms of shoulder dislocation and instability include:

• General joint insecurity and instability
• Shoulder pain
• Feelings of shoulder laxity
• Visual joint deformity

Some patients may have a lax shoulder without having injured the joint. This is most commonly seen in patients who do overhead sports like volleyball and swimming or patients who are "loose-jointed." These patients experience shoulder pain without dislocation (multidirectional instability).

How are shoulder dislocations and instability treated?

Treatment of shoulder instability varies according to the many different presentations and types. Most of the time, the Alta Orthopaedics team starts your treatment with conservative therapies such as:

• Anti-inflammatory medications
• Physical therapy
• Steroid injections

After a shoulder dislocation, you might need to wear a sling for a brief period. Physical therapy is then used to help you regain the strength and motion of your shoulder joint.  Biologics such as PRP (platelet-rich plasma) may also help speed up the healing process.

If conservative treatments fail, sometimes surgical intervention is necessary. This usually takes the form of a labral repair done arthroscopically through a minimally-invasive approach.

Although rare, some patients with recurrent instability have missing bone. In these cases, the orthopaedic surgeons at Alta Orthopaedics may use bone from your shoulder blade to enlarge the glenoid and help keep the shoulder from dislocating.

If you're having ongoing problems with shoulder dislocations or instability, call Alta Orthopaedics to schedule a consultation or book an appointment online today.