Shoulder Instability is the result of a condition or injury in which the “ball” of the joint physically moves out of the “socket”. Shoulder instability can generally be classified as mild to severe. In cases of severe instability, the ball dislocates completely out of the socket and may require shoulder joint surgery. In less severe cases the ball may only partially slip or “sublux.”
The main component of the shoulder joint (gleno-humeral joint) mechanically works as a very shallow “ball and socket”. This shallow socket allows for increased shoulder mobility as seen in throwing, swimming and other overhead activities. A certain segment of the population is naturally more loose in the shoulder stabilizing structures (joint capsule/ligament). These individuals will experience a greater incidence of either subluxation or dislocation events.
An unstable shoulder may also be as a result of a traumatic event known as a dislocation from an unusual fall with sports such as football, snow skiing, surfing or accidental fall from a ladder. This is more commonly seen in the “under 40” population.
When a dislocation occurs, or patients experience chronic, repetitive subluxations, there may be secondary associated injuries such as chronic tendonitis, tear of the rotator cuff tendon, tear of the labral tissue which surrounds the socket and provides for increased stability. These more involved diagnoses should be made by the orthopaedic physician and may require special imaging to visualize, which may in turn lead to shoulder joint surgery.
In the event of a dislocation, it may require intravenous sedation or anesthesia less commonly to “relocate” the shoulder joint. Pain medicine and anti-inflammatories are usually prescribed for several days thereafter. A sling should be worn for healing purposes for several weeks thereafter. X-rays should be taken to insure no incidence of fracture.
Due to the nature of the shoulder anatomy and mechanics, the shoulder joint in a certain segment of the population is the most commonly dislocated joint. Even with improved rehabilitation techniques there is often a recurrence rate of up to 80 %. It has been found with chronic recurring shoulder dislocations or symptomatic subluxations that shoulder stabilization surgery, also known as Bankart repair to stabilize the loose capusular ligaments is usually necessary and can be very successful. This shoulder stabilization surgery, or Bankart repair, can in most instances be performed arthroscopically.
Post operative physical therapy will be necessary to insure that proper progression of strength and mobility is achieved.
For more information on how the shoulder stabilization surgery specialists at Cary Orthopaedics can help you, contact us today at 919-467-4992 for an appointment!
Cary Orthopaedics serves patients from Raleigh, Garner, Cary, Apex, Holly Springs, Fuquay-Varina, Clayton, Chapel Hill, and Pittsboro, NC