What is the Treatment for Shoulder Instability?

The treatment for shoulder instability depends on the severity and cause of the instability. Here are some common treatment options:

1. Conservative Management:

   • Physical Therapy: A structured physical therapy program can help strengthen the muscles around the shoulder joint, improve shoulder stability, and enhance proprioception.
   • Activity Modification: Avoid activities that exacerbate shoulder instability, such as overhead lifting or contact sports.
   • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Over-the-counter medications like ibuprofen or naproxen can help reduce pain and inflammation.
   • Shoulder Bracing: Depending on the type and cause of instability, your doctor may recommend wearing a shoulder brace or sling to provide support and limit excessive movement.
   • Rehabilitation Exercises: Focus on strengthening the rotator cuff muscles, scapular stabilizers, and other muscles that support the shoulder joint. Additionally, exercises to improve posture and shoulder mechanics may be beneficial.

2. Surgical Intervention:

   • If conservative treatments fail to provide relief or in cases of severe instability, surgery may be necessary to repair or stabilize the shoulder joint. Surgical options include:
     • Arthroscopic Stabilization: Minimally invasive surgery performed using small incisions and a camera (arthroscope) to repair torn or stretched ligaments and tighten the joint capsule.
     • Open Stabilization: In some cases, particularly with complex or recurrent instability, open surgery may be required to repair the damaged structures and stabilize the shoulder joint.
     • Bankart Repair: A surgical procedure to repair a torn labrum (a ring of cartilage around the socket of the shoulder joint) and reattach it to the rim of the shoulder socket.
     • Capsular Shift: A surgical technique to tighten and reinforce the joint capsule to improve stability.
     • Bone Grafting: In cases of bone loss or structural abnormalities contributing to instability, bone grafting procedures may be performed to restore bone stock and support.

3. Rehabilitation Post-Surgery:

   • Following surgery, a structured rehabilitation program supervised by a physical therapist is essential to optimize recovery and restore shoulder function.
   • The rehabilitation program typically focuses on regaining range of motion, strengthening the shoulder muscles, improving proprioception and neuromuscular control, and gradually reintroducing functional activities.

4. Lifestyle Modifications:

   • Depending on the cause of shoulder instability, making lifestyle modifications such as avoiding repetitive overhead activities, maintaining good posture, and practicing proper lifting techniques can help reduce the risk of recurrence.

The choice of treatment depends on various factors, including the severity of instability, the patient's age, activity level, and overall health. It's essential to consult with a healthcare provider, preferably a shoulder specialist or orthopedic surgeon, to determine the most appropriate treatment plan based on your specific condition and goals.

Author

Dr. Catherine Logan, MD, MBA Catherine Logan, MD, MBA, MSPT, is a sports medicine orthopaedic surgeon specializing in complex knee and shoulder surgery at Colorado Sports Medicine and Orthopaedics (COSMO) in Denver, Colorado. As a former physical therapist & trainer, Dr. Logan provides a distinct expertise in sports injury, prevention, and surgical management.