Shoulder instability

Sometimes it actually pops out and reduces on its own, or it has to be reduced in hospital. Each time it is unpleasant, and one thought remains in your mind: ‘I just hope it does not come out again.’ This is not a matter of a weak shoulder or bad luck. It is shoulder joint instability.

What is actually happening?

The shoulder joint is the most mobile joint in the human body and therefore also the easiest to destabilize. The head of the humerus sits in the socket, a hollow in the shoulder blade, where it is secured by the labrum and ligaments that act like a seal and seat belts. When these structures tear during a dislocation or injury, the humeral head can escape the socket too easily. From then on, with certain movements the shoulder simply ‘gives way’ from the joint.

It most often begins with the first dislocation, after a fall or during training. If the labrum is damaged, further dislocations may occur increasingly easily, even during everyday activities. Strengthening the muscles that stabilize the shoulder can improve its function, but this may not be enough for young, athletic people or extensive injuries.

How can you recognize it?

• the shoulder has popped out at least once and had to be reduced,
• you feel it is about to pop out or snap when the arm is raised and drawn backward, for example when throwing a ball or reaching behind you,
• snapping, a feeling of instability, and apprehension occur with excessive movement,
• you avoid certain arm positions and instinctively protect it.

Why you should not wait

Every time the shoulder pops out or shifts, the humeral head rubs against the edge of the socket. Each such event damages the articular cartilage and, over time, also causes bone loss at the socket rim. The greater this loss, the greater the instability of the shoulder joint and therefore the risk of further dislocations.

And this is the trap. At first, repairing the torn labrum is usually enough. Later, once bone loss has occurred, the missing part of the socket must also be rebuilt, requiring a much more serious and extensive procedure. A shoulder treated after the first dislocation episodes returns to full function much more often than one that has dislocated for years.

How we help

We begin with a consultation and imaging studies. An X-ray shows the general condition of the bones, while computed tomography precisely assesses how much bone is missing from the socket and humeral head. Magnetic resonance imaging, preferably with contrast injected into the joint, is necessary to define in detail the extent of damage to the labrum and any other injuries that may need repair. Only the complete physical examination, imaging, and the patient’s individual expectations determine the scope and extent of surgery.

When only the labrum is damaged, we repair it arthroscopically. Through several millimeter-sized incisions, we insert an arthroscope, a miniature camera that displays the inside of the shoulder enlarged on a monitor. We reattach the labrum to the socket with anchors. If bone loss is present, we reconstruct the socket rim with a graft, recreating the missing bone so the humeral head again has secure support. This technique is more extensive and requires greater surgical access.

We operate using minimally invasive techniques: the wounds are small, heal faster, and you regain function early.

There is one goal: a stable shoulder that meets your expectations in sport, work, and everyday life.

Book a consultation

If your shoulder has already popped out or you feel it is about to, do not wait for another episode. Make an appointment before it becomes too ‘loose.’ We will determine exactly what is happening and tell you which treatment will solve your problem.