Shoulder instability occurs when the top of your arm bone slides out of the socket, leading to pain. Often, sudden injury or engaging in sports or activities that involve frequent overhead motions can cause this to happen.
Visiting orthopedic shoulder and sports medicine surgeon Dr. Matthew Pifer for a thorough evaluation is the best way to confirm whether you have shoulder instability. If you do, he offers a variety of treatment options. For now, here’s what you should know about shoulder instability and its treatments.
An overview of shoulder anatomy
The shoulder is made up of the upper arm bone (humerus), the shoulder blade (scapula), and the collarbone.
The upper arm bone's head fits into a shallow socket called the glenoid in your shoulder blade. The shoulder also has strong ligaments, known as the shoulder capsule, which keeps the head of the upper arm bone centered in the glenoid socket. This tissue protects the shoulder joint and connects the upper arm bone to the shoulder blade.
The tendons, ligaments, and muscles work together to keep the shoulder stable.
Why do I have shoulder instability?
Dislocation and hypermobility of the shoulder are the two most common causes of shoulder instability. Shoulder dislocation is frequently caused by sudden injury. When the humeral head dislocates, the socket bone and the ligaments in the front of the shoulder are usually affected.
An initial dislocation might cause further dislocations or chronic instability.
Some people have loose shoulder ligaments (hyperlaxity). This may be something you’re born with or may happen as a result of repeated overhead motion. Certain sports increase the risk of shoulder hypermobility and instability, including swimming, tennis, and volleyball.
You’re also at a higher risk of shoulder instability if you have loose ligaments throughout your body.
Forms of shoulder instability
There are three types of shoulder instability:
Most people with shoulder instability have anterior shoulder instability. This happens in the anterior direction and tends to occur from dislocation or hyperlaxity.
Posterior shoulder instability
Posterior instability is caused by muscle contractions rather than injury. In this type of shoulder instability, the head of the humerus is dislocated from the posterior labrum and the glenoid socket.
Multidirectional shoulder instability
Multidirectional shoulder instability, unlike anterior and posterior shoulder instability, is not caused by dislocation or injury. This sort of instability occurs from glenohumeral joint capsule hyperlaxity or laxity caused by repetitive overhead motions.
After a rotator cuff injury or tear, someone with congenital hyperlaxity or developed laxity is especially vulnerable to chronic multidirectional instability.
Treating shoulder instability
Relieving pain and discomfort and restoring shoulder function are top priorities when you have shoulder instability. Nonsurgical treatments are often the first recommendation for shoulder instability. However, depending on various factors, surgery may be needed to stabilize the shoulder.
Changing your activity to avoid aggravating your shoulder can help ease symptoms. Physical therapy with specific exercises designed to strengthen the shoulder muscles can also help.
When surgery is required, Dr. Pifer aims to take a minimally invasive approach when possible. Dr. Pifer specializes in arthroscopy, which is a minimally invasive approach that uses a tiny camera and special equipment to view and repair the shoulder. In some cases, open surgery is necessary. This involves making an incision across the shoulder and completing the repair.
Dr. Pifer offers expert diagnosis of and treatment of shoulder instability. You can expect specialized care to help you get back to the activities you enjoy. To get started with your initial consultation, call our Santa Barbara, California office and a scheduling coordinator will assist you.