Recurrent shoulder dislocation means the shoulder comes out of place more than once, and shoulder instability is the feeling that the joint is loose or about to slip. This page explains the causes and the treatment options.
Note: Repeated dislocations can damage the cartilage and bone around the joint, so do not ignore them. See a doctor for assessment.
Symptoms
A person with this problem may notice the following, and an accurate diagnosis needs an examination:
- The shoulder slipping out with simple movements or during sleep
- A feeling that the shoulder is loose or about to give way
- Fear of lifting the arm or reaching behind
- Pain and clicking inside the joint
- Weakness or brief tingling in the arm
- Difficulty with sport or daily tasks
Causes
Dislocations often recur because the tissues that hold the joint did not heal well after the first one. Causes include:
- A torn labrum and ligaments around the shoulder socket
- Loss of some bone from the socket or the ball after a dislocation
- A first dislocation at a young age or in athletes
- Generally loose ligaments
- Returning to activity before the shoulder has stabilised
Diagnosis
The doctor asks how many times the shoulder has dislocated and how, then examines its stability, movement and strength. An X-ray helps assess the bones.
An MRI or CT scan is often requested to look at the cartilage, the ligaments and any bone loss, which helps decide the right plan.
Treatment options
Non-surgical treatment
Some patients benefit from physiotherapy to strengthen the shoulder muscles and improve control, together with changing the activities that trigger dislocation. If instability continues, non-surgical care alone is often not enough.
- Exercises for the rotator cuff and shoulder blade muscles
- Avoiding positions and movements that lead to dislocation
- A temporary brace or sling in some cases
- A supervised training programme for athletes
Surgical treatment
When dislocations recur or instability persists, surgery may be the right option to repair the damaged tissue and restore stability. Dr. Emeel Hourani treats these cases with arthroscopic shoulder stabilization, done through small incisions.
Some cases, such as those with clear bone loss, may need a different approach, which the surgeon decides after assessment.
Recovery and rehabilitation
Recovery time varies from person to person and is set by the surgeon. Good rehabilitation is a key part of treatment.
- Protecting the shoulder in a sling after surgery as instructed
- Gradually moving the joint
- Strengthening the muscles around the shoulder
- Control and balance exercises
- A gradual return to activity and sport with the surgeon's approval
When to see the doctor
See a doctor if:
- Your shoulder has come out of place more than once
- The shoulder feels unstable during movement
- You avoid normal activities for fear of dislocation
- You have numbness, paleness or coldness of the hand after a dislocation, which is an emergency
- You want to return to sport after a previous dislocation