Shoulder instability: Options for rehab and surgery

Shoulder dislocations are challenging injuries for young athletes. For the ones who face shoulder instability, or repeated episodes of the shoulder popping out of place, the problem can interfere with their ability to play sports, exercise or even their normal activities at work and school.

Traumatic shoulder dislocations

Traumatic dislocations in young athletes can become a recurrent problem. Often the labrum pulls off the glenoid (socket) and the capsule stretches out when the initial injury occurs. Initially a large force is needed to cause the ball to slide out of the socket. With repeated injuries, less force is needed. It can even start to occur with normal use of the arm.

Also read:
5 signs your shoulder injury could be serious

Diagnosis and surgical treatment for shoulder dislocations

For traumatic shoulder dislocations, physical therapy can be a good place to start to regain strength, motion and function of the arm. Often orthopedic surgeons will order an MRI or MR arthrogram (MRI with contrast injected into the shoulder before the test) to see if there is any labral or capsular damage. In recent years, we have started to pursue arthroscopic surgical treatment earlier in younger patients to fix the damage before repeated shoulder instability events occur.

Surgical photo of repair of shoulder labral tear for shoulder instability

Multi-directional shoulder instability

Another category of shoulder instability is multi-directional instability. These are dislocations or subluxations (partial dislocations) that can occur in patients who are naturally lax in their joints. These events often occur without an initial traumatic event.

Also read:
Can you return to play after a shoulder dislocation?

Rehab for multi-directional shoulder instability

Often young patients with multi-directional instability can benefit from a course of physical therapy. The strengthening of muscles around the shoulder can decrease pain and help to stabilize the shoulder. Often physical therapy is sufficient to solve the problem. Occasionally surgery to tighten the capsule around the shoulder is necessary.

Also read:
Arthroscopic shoulder surgery: What you need to know

In this video, I discuss traumatic and multi-directional shoulder instability and treatment options for both issues.