The joint with the most mobility is the shoulder. It does many functions as lifting the arm, rotating it, and reaching up to your head. It can be turned in many directions. But this substantial amount of mobility can be the reason for instability in the shoulder.
Instability in the shoulder is the result of upper arm bone forcing out of the shoulder socket due to a sudden injury, such as a fall or accident.
After the dislocation, it is susceptible to repeated incidents known as chronic shoulder instability.
Cause
There are three common causes for shoulder instability
Shoulder Dislocation
The reason for shoulder dislocation is mostly due to major injury or trauma in the beginning.
The head of the humerus dislocates resulting in the injury of socket bone and the ligaments in the front of the shoulder. The labrum may also get injured, frequently known as a Bankart Lesion. The initial dislocation can give rise to constant dislocations, resulting in instability.
Hyperlaxity
The second reason for shoulder dislocation is hyperlaxity. This is the condition of having looser ligaments in the shoulder as normal anatomy in some people.
At other times it can be the result of routine overhead motion. Some of the sports that need repetitive overhead motion are swimming, tennis, and volleyball that can give rise to hyperlaxity. Many professions also need repetitive overhead work.
It can become very tedious to maintain shoulder stability in case of looser ligaments resulting
in a painful, unstable shoulder.
In some patients, the shoulder can be unstable without any injury or repetitive burden. In such cases, the shoulder can be loose or may dislocate in many directions. This indicates that the ball may dislocate in the front, out at the back, or may come out under the shoulder. The situation is called as multidirectional instability.
Symptoms
The main signs of severe shoulder instability are
- Repetitive dislocations of the shoulder
- Repetitive incidence of the shoulder coming out
- The shoulder feeling loose, slipping in and out of the joint, or just hanging there
Pain due to a shoulder injury
Treatment
Severe shoulder instability is generally attended with nonsurgical methods at first. In case they are not effective in decreasing the pain and instability, surgery is needed.
Nonsurgical Treatment
A proper treatment method will be laid out by the doctor to relieve the symptom. It may take many months of medication before the proper effectiveness is measured. The process of non-surgical methods are as follows
Activity modification— some modifications may be needed in lifestyle and refraining from those work that may increase the condition.
Non-steroidal anti-inflammatory drugs — to reduce pain and swelling anti-inflammatory drugs like aspirin, ibuprofen, and naproxen may be administered.
Physical therapy.—The control on the shoulder can be increased by making the shoulder muscle strong by working on it which in turn can increase stability.
Surgical Treatment
Surgical procedures are given to patients with repetitive dislocations for repairing worn-out or overworked ligaments to give them a better hold on the shoulder joint.
Arthroscopy— a minimally invasive procedure is used to treat soft tissues in the shoulder. Arthroscope helps the surgeon to view inside the shoulder with a tiny camera and do the surgical process with special tiny instruments. Arthroscopy is a same-day procedure.
Open Surgery— may be needed by some patients. In this process, a cut is made over the shoulder and the repair is done under direct vision.
Rehabilitation.— A sling may be used to hold your shoulder after surgery for some time.
After the removal of the sling, exercises are to be done for rehabilitating the ligaments. These exercises are important in bringing back the range of motion in the shoulder and preventing scarring of the healing ligaments.