The shoulder has one of the largest and most complex joints in the whole body. It is made up of three main bones: the collarbone (clavicle), shoulder blade (scapula), and humerus (long bone of the upper limb). Together, these three prominent bones make up four pairs of joints, namely:
- Glenohumeral joint – main shoulder joint
- Acromioclavicular joint
- Sternoclavicular joint
- Scapulothoracic joint or the floating joint
These four joints help the shoulders become flexible and have a greater range of motion than any other body part. However, this is also what makes the shoulders prone to major injuries, such as dislocations and instability.
In fact, studies reveal that shoulder dislocation represents 50% of all major joint dislocations sent to the hospital and ER. Once a shoulder is repeatedly injured and dislocated, that only increases its chances of sustaining instability.
Below is an in-depth discussion on shoulder instability一what it is, its causes, symptoms, and how to treat this condition.
What is shoulder instability?
Shoulder instability refers to a condition that happens when the glenohumeral joints (shoulder) are too loose. This causes the humerus to move too much inside the socket (glenoid) or slip out, causing discomfort and loss of function. This shoulder injury may occur for various reasons, such as:
Physical trauma or sudden injury
Studies suggest that the most common cause of instability is those sustained in contact sports. It can also occur due to sudden, forceful accidents, such as falls and car crashes.
Overuse
This refers to the wear-and-tear that develops in the shoulder joints over time due to overuse. It can happen because of stressful, repetitive shoulder motions, such as baseball throwing.
Muscle damages and defects
The shoulder joint is surrounded by various ligaments and tendons that support its movement. When these structures get damaged, the joint may become loose and prone to instability. Some examples include labral tears and lesions.
Genetics
Congenital instability refers to a condition wherein a part/s of the shoulder bone or muscle is underdeveloped, making an individual vulnerable to shoulder injuries. For example, a person born with glenoid dysplasia has an underdeveloped socket, causing it to be too spacious. This can then result in shoulder instability even without any injury to trigger it.
In most cases, shoulder instability often results in complete dislocation of the shoulder joints. Once that happens, then the joints are now prone to repeat episodes of dislocation, causing a condition called chronic shoulder instability.
If not medically addressed, your unstable shoulder joints can cause arthritis, damaging your bones further.
What are the symptoms of shoulder instability?
People with shoulder instability experience different symptoms depending on the cause of their condition. Generally, instability can cause the following physical manifestations:
- Clicking sound in the shoulder joint area
- A feeling of “looseness” in the shoulders, especially when doing specific shoulder movements or activities.
- Feeling like your shoulder joints are moving or shifting when you do particular tasks.
- Decreased range of motion
- Numbness or tingling in the arms
- Repeated episodes of dislocation
- If an injury causes it, patients may experience pain with swelling and bruising.
It’s crucial to see an orthopedic specialist in Miami immediately if you ever experience any of these signs and symptoms.
How is shoulder instability diagnosed?
Doctors can initially diagnose this condition through physical examination and patient history. Your physician can palpate the shoulder area and move it in specific directions to check its strength and range of motion.
Specific motion tests may also be done to see the degree and severity of the instability. Your doctor may also order several imaging examinations to confirm their diagnosis. This includes:
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- X-ray to see the structure of the shoulder joints.
- MRI or magnetic resonance imaging to get a detailed view of the soft tissues and muscles. This can help them identify other damages that may be causing your shoulder instability.
What are your treatment options?
Treatment options vary in the degree and severity of the shoulder’s condition. It may also depend on the mechanism of the injury or how it was caused.
Non-surgical treatment
In most cases, medical management usually involves non-surgical methods first. Your doctor may come up with a specific program that combines the following treatment methods:
- Activity modification – involves restricting specific tasks or activities that require too much shoulder movement, which may trigger instability. Activity modification can help reduce your symptoms and augment your healing process.
- Medication – non-steroidal anti-inflammatory drugs (NSAID) like aspirin and ibuprofen can help reduce shoulder pain and swelling. This, in turn, helps you do the required physical therapy and exercises needed for your recovery.
- Physical therapy – involves stretching and strengthening the shoulder muscles, specifically the rotator cuff muscles and deltoid. Physical therapy aims to restore shoulder control, motion, strength, and stability. Additionally, it helps with postural re-education and motor control training.
For shoulder instability resulting in dislocation, the shoulder may be placed in a sling or brace first to provide temporary immobilization.
Surgical treatment
Surgery is the last resort for shoulder conditions that do not respond well to conservative treatments. Your doctor may also recommend it for repeated episodes of dislocation or when there are muscle tears and damages. Some of the specific surgical procedures your orthopedic specialist may perform include:
- Arthroscopic surgery – is a minimally invasive surgical procedure to repair damaged shoulder joints and muscles. This only requires a few tiny incisions to access the joints, thus resulting in minimal scarring and faster recovery.
- Open shoulder surgery – a more extensive open surgery should be performed to treat severe forms of instability.
After surgical treatment, your doctor may still recommend you to undergo physical therapy and rehabilitation for optimal recovery. This is important to help the shoulder regain its strength and range of motion back and check if the surgery successfully restored stability.
Get the proper shoulder treatment you need by consulting with South Florida Orthopedics
At SFIO, we specialize in providing the best orthopedic care and sports medicine in the Miami area. We aim to give you the proper consultation, diagnosis, and highest quality of treatment services that you deserve.
Our orthopedic specialists are the expert in handling different kinds of musculoskeletal conditions, such as:
Contact us now at our Miami (305) 233-0011 office. You can also request an appointment at our website so we can accommodate you as soon as possible.
The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.
