Shoulder Dislocation & Instability

The ball-and-socket shape of your shoulder joint allows for a wide range of motion — you can reach up high to climb a mountain face, behind your back to scratch an itch or out to the side to paddle a canoe. Yet the versatility of this joint can also make it prone to dislocation.

Dislocation occurs when the head of the upper arm bone, known as the humerus, pops out of the shoulder socket. Dislocation most commonly happens the first time due to a traumatic injury, such as a fall. But once it’s happened, the risk of future dislocations increases. This is because the ligaments and other surrounding tissues, which help stabilize the shoulder, can become torn or stretched during dislocation.

There are two types of shoulder dislocations:

Subluxation. The humerus partially slides out of place.

Complete dislocation (luxation). The humerus slides all the way out of the socket.

Chronic shoulder instability occurs when the shoulder repeatedly slips out of place, and each episode can further damage the surrounding tissues. Chronic instability can also develop in people who have never experienced a traumatic injury but naturally have loose shoulder ligaments — a condition known as hyperlaxity.

Symptoms of shoulder instability

If you suspect your shoulder has been dislocated, you should seek immediate medical attention. Dislocation is often accompanied by sudden, intense shoulder pain and the shoulder may appear visibly out of place. You may also experience numbness, tingling or weakness in the arm or hand on the affected side.

Common symptoms of chronic shoulder instability include:

• Repeated shoulder dislocations
• Pain in the shoulder during specific movements
• Persistent feeling that the shoulder is loose or unstable
• Clicking or grinding sensations in the shoulder
• Loss of strength or decreased range of motion

Early intervention for chronic shoulder instability can improve outcomes and prevent long-term joint damage. Consult a specialist if:

• Pain persists for more than a few weeks
• Rest and at-home pain management strategies are not improving symptoms
• Pain and discomfort are interfering with your ability to sleep or perform daily tasks
• Your shoulder feels stuck or like it’s frequently slipping out of place during certain activities
• Your shoulder cannot bear weight
• You hear popping or other unusual noises during shoulder movement

Diagnosing shoulder instability

To make a diagnosis, your orthopedic specialist will discuss your medical history and conduct a physical exam to assess for pain, instability and range of motion. They may also recommend imaging tests to confirm a diagnosis.

• X-rays can help uncover the cause of shoulder instability and rule out bone-related injuries like fractures.
• MRIs can help evaluate damage to ligaments and other soft tissues. In some cases, a special dye may be injected into your shoulder joint to help your care team better visualize the area.
• CT scans can help further evaluate the shoulder joint, particularly if you’re experiencing repeated dislocations.

Treating shoulder instability

Treatment depends on several factors, including the severity of your dislocation, your activity level and whether your shoulder instability is chronic. We offer both nonsurgical and surgical options tailored to your individual needs.

Nonsurgical treatments

In many cases, shoulder instability is first treated with nonsurgical approaches:

• Gentle repositioning of the shoulder (often with anesthetic)
• Rest and activity modification to support healing
• Temporary immobilization with a sling
• Anti-inflammatory medications to ease pain and swelling
• Physical therapy to strengthen shoulder muscles and improve stability

Surgical treatments

You may benefit from surgery if you’re experiencing repeated dislocations, there’s significant damage to soft tissues in your shoulder or nonsurgical options aren’t providing sustained relief. Surgical options include:

• Arthroscopic procedures, using minimally invasive techniques, to repair soft tissues
• Open surgery to correct severe cases of instability

Postoperative rehabilitation can help you further regain strength and mobility. While recovery looks different for everyone, most patients gradually return to the activities they enjoy.