Shoulder conditions
Shoulder instability
When the shoulder slips partly or fully out of its socket, often after a dislocation, leaving a sense that the joint may give way.
Joint slips or dislocates
Common in young athletes
Often repairable
What is shoulder instability?
The shoulder trades stability for its huge range of motion, relying on a rim of cartilage (the labrum) and surrounding ligaments to keep the ball in its shallow socket. Instability occurs when those restraints are stretched or torn and the ball slides too far.
It ranges from a full dislocation that must be put back in place, to subtle slipping (subluxation) and a constant apprehension that the shoulder will give out, especially with the arm raised and rotated back.
Overview
At a glance
Why it matters
Each dislocation can cause more damage and make the next one more likely. Addressing instability early protects the joint over the long term.
Symptoms & signs
How instability feels
Symptoms depend on whether the shoulder fully dislocates or simply slips.
A history of one or more shoulder dislocations
A feeling that the shoulder is loose or about to slip out
Apprehension when the arm is raised and rotated outward
Repeated episodes of the shoulder catching or giving way
Pain and weakness after an episode
Causes & risk factors
What causes instability
Instability usually starts with an injury, but some people are simply built looser.
Traumatic dislocation
A fall or collision can tear the labrum and ligaments (a Bankart tear).
Repetitive overhead sport
Throwing and swimming can gradually stretch the restraints.
Natural laxity
Some people have looser ligaments that allow multidirectional instability.
Bone loss
Repeated dislocations can wear away bone, making the joint less stable.
Treatment options
How instability is treated
First-time, low-demand cases may settle with therapy; recurrent instability usually benefits from repair.
- A focused rotator cuff and scapular strengthening program
- Activity modification to avoid at-risk positions
- Bracing for sport in select cases
- Time to allow a first dislocation to calm down
- The torn labrum and ligaments are reattached to the rim
- Minimally invasive, through small keyhole incisions
- Bone procedures added when significant bone is lost
- Highly effective at preventing further dislocations
Related procedure
When the shoulder keeps slipping, Dr. Cohn performs an arthroscopic shoulder stabilization.
Recovery
What recovery looks like
Stabilization recovery balances protecting the repair with restoring motion.
Protect
A sling protects the repair while the labrum heals to the rim.
Restore motion
Therapy gradually returns full range of motion.
Strengthen
Progressive strengthening rebuilds the stabilizing muscles.
Return to sport
A staged return to contact and overhead sport once strength and control return.
FAQ
Common questions
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Not always. A first dislocation in an older or low-demand patient may settle with therapy. Young athletes are far more likely to re-dislocate and often benefit from repair.
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Most patients regain full strength and a stable shoulder after stabilization and rehab, returning confidently to their activities.
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It's a tear of the labrum off the front of the socket, the most common injury from a dislocation, and exactly what stabilization repairs.
Related procedures