Shoulder Instability

Shoulder instability occurs when the structures that keep the shoulder joint in place including the ligaments, labrum, and rotator cuff muscles become weakened or stretched. This makes the shoulder prone to slipping, subluxation (partial dislocation), or full dislocation. Instability can develop gradually from repetitive overhead movements (such as throwing or swimming) or result from a traumatic injury. Once the joint becomes unstable, the risk of future dislocations increases significantly.

Diagnosis of Shoulder Instability

Shoulder instability is diagnosed through:

Medical history review (injuries, sports activity, or repetitive strain).
Physical exam to assess laxity, painful motion, and stability tests.
Special tests such as the apprehension test or relocation test to evaluate instability.
Imaging (MRI or CT scans) to check for labral tears, ligament damage, or bone loss.

Treatment for Shoulder Instability

Physical therapy is the cornerstone of treatment for shoulder instability, focusing on strengthening and stabilizing the joint. A rehab plan may include:

Strengthening exercises for the rotator cuff and scapular stabilizers
Proprioceptive training to improve joint control and awareness
Manual therapy to restore normal joint mechanics
Postural correction to reduce strain on the joint
Activity modification to avoid high-risk positions until stability improves
Education on safe return-to-sport or work progression
If instability is severe or persistent despite therapy, surgical options may be recommended to repair torn ligaments or labrum, followed by rehabilitation.

Symptoms of Shoulder Instability

Common signs and symptoms of shoulder instability include:

A “slipping” or “loose” feeling in the shoulder joint
Pain during overhead or throwing movements
Weakness or fatigue in the shoulder
A clicking or popping sensation with movement
Recurrent dislocations or subluxations
Avoidance of certain arm positions due to fear of dislocation

Prevention of Shoulder Instability

To prevent shoulder instability or reduce the risk of recurrence:

Maintain strong rotator cuff and upper back muscles
Avoid repetitive overhead activity without proper rest
Use correct form when lifting or performing athletic movements
Warm up and stretch before sports
Wear protective gear during contact sports
Follow through with a strengthening program after any dislocation or injury