Shoulder instability is a condition which effects millions of Americans each year. Shoulder instability occurs when the head of the upper arm bone slips out of the shoulder socket. This condition is more common than people realize and can cause pain, frequent shoulder dislocations and limited range of motion. If left untreated, shoulder instability can cause joint deterioration.
One of the main ways to avoid experiencing shoulder instability is to understand the common reasons it can occur.
The Importance of the Shoulder
To understand shoulder instability, one must first understand the role that the shoulder plays in the human body. The shoulder is comprised of a ball and socket type joint and serves many functions. The shoulder is vitally important to arm movement and is what helps a person rotate their arm, lift their arm, reach their arm, and carry items. Because the shoulder is so mobile and has a wide range of motion, it is inevitably susceptible to injury and instability conditions.
Shoulder Instability: A Further Examination
According to experts, one of the main causes for shoulder instability is physical trauma to the shoulder resulting from a fall or accident. This is especially true when a person has previously dislocated their shoulder as previous dislocation makes it easier to sustain additional dislocations in the future.
Similarly, patients who are actively involved in athletics throughout their lives may have chronic shoulder instability. “One of the most common causes of shoulder instability is injury or overuse in athletics”, says Dr. Brian Cable, an orthopedic surgeon specializing in upper extremity injury. “Individuals who have a long history of playing a sport which requires heavy reliance on the shoulder—such as tennis or swimming—are susceptible to developing shoulder instability.
Those who play sports are not alone in shoulder instability. Indeed, some patients may experience shoulder instability even though they never dislocated their shoulder. This is due to a person being born with loose ligaments, which can cause instability and result in pain. Some patients may also suffer from a genetic condition that causes looseness in the shoulder joints, therefore predisposing said patients to shoulder instability or weakness.
Symptoms of shoulder instability include pain, a loose sensation as through the shoulder is sliding out of its socket, repeated shoulder dislocations, limited range of motion, swelling, weakness, repeated instances of the shoulder giving out and restricted mobility.
Treatment Options for Shoulder Instability
If shoulder instability is suspected, it is important to first rest and avoid aggravating activities for several days. Consultation with a physician such as an orthopedic shoulder specialist is also of vital importance. A patient history will be obtained which includes a comprehensive look at whether someone has any prior medical conditions or prior shoulder injuries. A physical examination is necessary to evaluate the shoulder’s range of motion and strength. Thereafter, imaging such as x-rays or a magnetic resonance imaging (MRI) may be ordered to definitively diagnose the shoulder instability and rule out any other potential problems that may be contributing to someone’s symptoms.
Once shoulder instability is diagnosed, there are both nonsurgical and surgical treatment options. These options are case specific and largely dependent on a person’s symptoms and objective findings on radiographic imaging. Typically, more conservative, nonsurgical options, are the first to be explored with a patient. Nonsurgical treatment options include a course of physical therapy focused on strengthening and conditioning the shoulder muscles, lifestyle changes such as refraining from activity that can aggravate symptoms or prescriptions for anti-inflammatory drugs such as aspirin, naproxen, or ibuprofen.
Surgical treatment options may be discussed if a patient has repeated issues with dislocation that have not resolved following non-surgical treatment or if a torn or stretched ligament is revealed on an MRI. Surgical options can restore the structure and integrity of damaged shoulder ligaments, tendons, and muscles. Arthroscopic surgery may be recommended, which is a minimally invasive procedure that can be completed on an out-patient basis.
An open surgical procedure may also be recommended, which is a more complex surgery which allows the surgeon to fully visualize the shoulder and complete a repair. Open surgeries are typically recommended when there is severe shoulder instability.
Following surgery, the shoulder may be immobilized for a brief recovery period. A course of physical therapy or a home exercise program may be recommended. While treatment may seem like a slow and arduous process, following a treatment plan is critical to resuming normal activity levels and living life to its fullest. Many patients will regain full range of motion in their shoulder six to eight weeks after surgery. The chance of reoccurrence of shoulder instability following surgery is quite low and most patients can return to their previous activities.
In the end, shoulder instability is a very common cause of pain and concern for many people. It can occur for many reasons, including but not limited to prior shoulder dislocation, trauma, or a genetic condition causing loose ligaments. Thankfully, treatment has advanced considerably to the point where those afflicted can get the help they need, which in and of itself is the most important benefit of all.
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