How does shoulder instability occur?
Shoulder instability can be down to a genetic predisposition. It can be triggered by minimal trauma (atraumatic) or by high-energy trauma (e.g. a fall whilst skiing) and in both cases result in the shoulder slipping out of joint.
The consequence is normally a tear and/or massive extension of the capsular ligament apparatus, usually in combination with a rupture of the labrum. As a result, even relatively insignificant stresses can cause repeated luxation of the joint.
Treatments for shoulder instability
For the traumatic form of shoulder instability, physiotherapy is unable to offer a cure in the vast majority of cases.
To avoid recurrent or repeat shoulder luxations, surgical reconstruction of the capsular ligament apparatus and the labrum is therefore almost always the treatment of choice. The procedure is usually carried out with the arthroscopy. Concomitant damage can therefore be assessed and treated more accurately compared to open procedures.
The operation can be carried out as a day case. The arm is protected after the operation and its movement limited for 6 weeks.
See a shoulder specialist
Arthroscopic stabilisation techniques demand a high degree of experience and technical expertise, and this something that sufferers should bear in mind when choosing their surgeon. Depending on the clinical picture, the surgeon may re-tighten the joint capsule and ligament structures to their normal length, for example, and suture a torn fibrocartilaginous ring to the edge of the joint socket.
In the case of atraumatic shoulder instability, physiotherapy treatment is rarely sufficient to stabilise the joint by strengthening the muscles. To permanently prevent luxation, on the other hand, arthroscopic reconstruction is usually required here too.