The shoulder joint is the most mobile in the body and is, therefore, at risk for instability. Shoulder instability is very common, with the shoulder being the most commonly dislocated joint in the human body. Shoulder instability occurs when the head of the upper arm bone is forced out of the shoulder socket and is dislocated.
The shoulder can completely dislocate and become stuck, requiring relocation, or it can partially dislocate (a subluxation). Once a shoulder has dislocated, it is vulnerable to repeat episodes. When the shoulder is loose and slips out of place repeatedly, it is called chronic shoulder instability.
In patients who sustain a traumatic dislocation, the younger the age of the patient at the time of the first dislocation, the more likely he/she is to develop recurrent instability. Repeated dislocations can become painful and quite disabling over time.
Causes of Shoulder Instability
Shoulder instability results in tearing of the labrum (ring of cartilage around the shoulder socket) or looseness of the capsule and ligaments that hold the shoulder joint in place.
Severe injury, or trauma, is often the cause of an initial shoulder dislocation. When the head of the humerus dislocates, the socket bone (glenoid) and the ligaments in the front of the shoulder are often injured. The labrum — the cartilage rim around the edge of the glenoid — may also tear. This is commonly called a Bankart lesion. A severe first dislocation can lead to continued dislocations, giving out, or a feeling of instability.
Strain and Looseness
Some people with shoulder instability have never had a dislocation. Most of these patients have looser ligaments in their shoulders. This increased looseness is sometimes just their normal anatomy. Sometimes, it is the result of repetitive overhead motion.
Swimming, golf tennis, and volleyball are among the sports requiring repetitive overhead motion that can stretch out the shoulder ligaments. Many jobs also require repetitive overhead work.
Shoulder Instability Treatment near Seattle
Treatment for shoulder instability typically begins with physical therapy to strengthen the muscles around the shoulder and prevent further dislocations. If this is unsuccessful, surgical stabilization may be necessary. Modern, minimally invasive arthroscopic techniques can be used to stabilize the shoulder successfully in the vast majority of patients, leading to shorter recovery times and improved cosmesis, compared to open stabilization.
Bankart Repair for Shoulder Instability
The Bankart Repair is done to repair labral tears, but these tears are typically related to shoulder dislocation and instability. When a person dislocates their shoulder, part of the labrum is often torn. While a labral tear isn’t necessarily painful, it can cause some discomfort and lack of mobility on its own. However, the biggest issue with labrum tears is that they can lead to more instability and shoulder dislocations in the future if left untreated.
Labral tears are treated by reattaching and tightening the torn labrum and ligaments of the shoulder (see slideshow below). This usually done using sutures and small bone anchors. An anthroscope is inserted through a small slit in the skin on the back of the shoulder, and small tools enter through portals on the front of the shoulder.