Shoulder Instability

The symptoms of shoulder instability can vary depending on the severity and frequency of dislocations. Common signs and symptoms include:

• Recurrent dislocations or subluxations: A sensation that the shoulder is loose or slipping out of place. This may happen during certain movements, such as raising the arm above the head or rotating it.
• Pain: Discomfort or sharp pain, particularly during physical activity or when the arm is moved in specific directions.
• Weakness: A feeling of weakness in the shoulder, especially when trying to lift objects or perform overhead activities.
• Limited range of motion: Difficulty moving the shoulder through its full range of motion due to discomfort or fear of dislocation.
• Clicking or popping: Sensations of clicking, popping, or grinding in the shoulder joint during movement.

Shoulder instability can be caused by various factors, including traumatic injuries, repetitive strain, and anatomical or genetic conditions. Common causes include:

• Traumatic injury: A sudden injury, such as a fall or direct blow to the shoulder, can cause the joint to dislocate. Once the shoulder has been dislocated, the structures supporting the joint may be weakened, leading to recurrent instability.
• Repetitive strain: Athletes, especially those who engage in overhead sports like baseball, swimming, or volleyball, may develop shoulder instability over time. Repetitive motions can overstretch the ligaments and tendons, making it harder for the shoulder joint to stay in place.
• Genetic factors: Some individuals are naturally more flexible or “double-jointed,” a condition known as hypermobility. This increased laxity in the joints can make the shoulder more prone to instability.
• Congenital conditions: In rare cases, congenital conditions affecting the connective tissues, or the structure of the shoulder joint can lead to instability from a young age.

Diagnosing shoulder instability involves a combination of patient history, physical examination, and diagnostic imaging. Dr. Connor Ziegler, a specialist in shoulder, elbow, and knee sports medicine in New England, carefully assesses each patient to determine the extent of the instability and to identify the best treatment plan. The diagnostic process typically includes:

1. Patient history: Understanding the patient’s symptoms, including any history of shoulder dislocations or pain, as well as any activities that may have contributed to the instability.
2. Physical examination: A thorough examination of the shoulder to check for signs of instability, pain, and weakness. The doctor may gently move the arm in various directions to assess the stability of the joint and pinpoint areas of discomfort.
3. Imaging tests: X-rays, MRI, or CT scans may be used to get a detailed view of the shoulder’s structures. These imaging tests help in identifying any damage to the ligaments, tendons, or bones that could be contributing to the instability.