What is shoulder instability?
The shoulder comprises a ball and socket, allowing it to rotate and move from side to side due to its versatility in movement. The shoulder is made up of the long humeral (upper arm) bone and the space within the shoulder blade. The humeral head is encased within the socket. The capsule, which is the joint’s lining ensures the humeral head is protected inside the socket.
Shoulder instability occurs when the shoulder is unable to move freely as a result of the following:
- Shoulder dislocation/subluxation occurs when the humerus slides out of place partially or completely due to a traumatic accident. Typically, a shoulder dislocation occurs when the humerus detaches from the glenoid. During shoulder subluxation or dislocation, the labrum, ligaments, or capsule detaches or stretches away from the bone.
- A labral tear develops when the labrum peels from the glenoid, which is likely to occur due to shoulder trauma or repetitive motion of the shoulder.
What are the signs?
As a result of shoulder instability, it most likely feels as if the shoulder is about to detach from the socket.
Other signs include:
- Pain
- Limited shoulder mobility
- Bruising and swelling in the shoulder
In order to diagnose the condition, your orthopaedic surgeon has to perform palpation to check the joint for signs of tenderness, poor range of motion and strength, which are all signs of shoulder instability.
What causes shoulder instability?
Shoulder instability may occur for various reasons related to shoulder dislocation, labral tears or genetics. For example, concerning genetics, some individuals are born with lax shoulder ligaments or spacious capsules. As a result, this makes them more prone to injury and shoulder instability.
How does Dr du Toit treat shoulder instability?
Pressure must be removed from a subluxated or dislocated shoulder by avoiding aggravating, weight-bearing activities. Shoulder bracing or a sling may be applied for a traumatic dislocation; this is only temporary until your orthopaedic surgeon can determine a more permanent, long-term solution to the problem.
Your treatment plan depends on the reason for shoulder instability and the severity of the condition. For example, conservative treatments such as cold therapy and prescription anti-inflammatories can help improve pain and swelling in the affected region.
However, if the condition is severe and pain does not improve with non-surgical treatment, Dr du Toit will recommend arthroscopic surgery. Arthroscopic surgery, which is done when the patient is under anaesthesia, involves placing a flexible scope with a camera and light attached through a small cut over the shoulder. Using the surgical instrument (arthroscope), Dr du Toit can assess the health of the rotator cuff tendons and labrum. If the extent of the laxity is mild, Dr du Toit will decide to stabilise the shoulder using less invasive arthroscopic techniques.