Shoulder Instability
A shoulder that's dislocated once wants to do it again. Stop the cycle.
Overview
Understanding shoulder instability
The shoulder trades stability for the widest range of motion of any joint — a golf ball on a tee, held by the labrum and capsule. When it dislocates, those stabilizers tear, and in young athletes the recurrence risk after a first dislocation is high.
Each dislocation can add damage: more labral tearing, stretched capsule, and in recurrent cases bone loss from the socket rim that changes which operation will work. That's why instability care is about interrupting the cycle early.
Symptoms
What it feels like
- A shoulder that has fully dislocated or repeatedly "slips"
- Apprehension — dread of the arm in the throwing position
- Pain and dead-arm episodes with overhead activity
- A sense of looseness with daily reaching
Common causes
Why it happens
- Traumatic dislocation during contact sport or a fall
- Repetitive overhead stress stretching the capsule
- Generalized ligament laxity
Diagnosis
How it's diagnosed
The exam characterizes direction and severity of instability. MRI (often with arthrogram) maps labral tears; CT quantifies bone loss when recurrent dislocations are in the story — because beyond a threshold of socket bone loss, soft-tissue repair alone has a high failure rate and a bone-restoring procedure is the reliable answer.
Treatment
The full range of options
Non-surgical
Structured rehabilitation
Strengthening the rotator cuff and scapular stabilizers restores dynamic control — a reasonable first path for lower-risk patients and non-athletes.
Activity and position management
Short-term avoidance of the provocative positions while control is rebuilt.
Surgical
Arthroscopic Bankart repair
Reattaching the torn labrum and retensioning the capsule through small incisions — the standard for first-time and early recurrent dislocators without significant bone loss.
Bone-block procedures (Latarjet)
For meaningful bone loss or failed prior repair, transferring a small block of bone to the socket rim restores the anatomy that keeps the ball in place.
Recovery
The road back
After stabilization, the labrum heals under protection: sling early, motion in phases, strengthening from about three months, and return to contact sport commonly around five to six months once strength and apprehension testing pass.
Dr. Johnson's approach
Dr. Johnson treats instability as a trajectory problem: the goal is stopping the dislocation cycle before it costs bone. Athletes get risk-honest guidance about timing around their season, imaging that actually quantifies bone loss, and the operation their anatomy calls for — not just the most common one.
Straight answers
Frequently Asked Questions
The information on this site is for education only and is not a medical diagnosis or a substitute for professional medical advice. Every patient is different — please consult Dr. Johnson or a qualified provider about your specific condition.
Ready when you are
Take the first step past shoulder instability
A focused evaluation, an honest conversation, and a plan built for your goals.