Shoulder Dislocations & Instability
What are Shoulder Dislocations & Instability?
The shoulder is the most mobile joint in the body and, as a consequence, the most commonly dislocated joint in adults. Associated injuries to the labrum (Bankart lesion), the humeral head (Hill-Sachs lesion) and the rotator cuff are common.
Following a first dislocation, the risk of recurrence is strongly related to age: in patients under 25, recurrence rates exceed 70–90% without surgical stabilisation. Shoulder instability can also occur without frank dislocation, as a spectrum of subluxation events or as multidirectional instability driven by ligamentous laxity. Specialist rehabilitation is the first-line treatment for all forms of shoulder instability and is essential following surgical stabilisation.
What causes Shoulder Dislocations & Instability?
- Fall onto an outstretched and rotated arm
- Direct blow to the back of the shoulder shoulder during sport or trauma
- Overhead throwing and contact sports: rugby, football, martial arts
- Generalised joint hypermobility causing multidirectional instability without significant trauma
- Repeated subluxation events from occupational or sporting activities
- Neuromuscular conditions causing dynamic shoulder instability through muscle weakness
Signs & symptoms
- Acute severe pain, deformity and inability to move the arm following traumatic dislocation
- A feeling of the shoulder 'going out' or slipping: the hallmark of recurrent instability
- Dead arm syndrome: a transient feeling of weakness or numbness in the arm during overhead activities
- Shoulder aching after activity and overnight following instability episodes
- Reduced confidence in using the arm for sport or overhead work
How Hand Therapy can help
Ms Razo provides specialist assessment and evidence-based treatment for Shoulder Dislocations & Instability. Following a thorough initial assessment, a personalised treatment plan will be developed to address your specific needs and goals.
Following reduction of an acute shoulder dislocation, a structured rehabilitation programme is initiated. Ms Razo designs a programme to restore pain-free shoulder movement and progressively strengthen to reduce the risk of recurrence.
Graded strengthening the cornerstone of non-surgical instability management. Specific exercises restore shoulder control to reduce the risk of further dislocation or subluxation episodes.
Where instability is recurrent or occurs in a specific shoulder position, a custom shoulder orthosis or soft brace may be used to provide external support during high-risk activities - particularly sport, while rehabilitation progresses.
Following Bankart repair, Latarjet procedure, capsular shift or other stabilisation surgery, Ms Razo provides specialist post-operative rehabilitation. The programme is phased appropriately to protect the surgical repair during initial healing, with progressive restoration of full shoulder movement, strength, work or sport-specific function.
Frequently asked questions
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The decision depends on age, activity level and associated injuries. In young, active patients, particularly those under 25 involved in contact sport, surgical stabilisation following a first dislocation significantly reduces recurrence rates compared to rehabilitation alone. Older or less active patients are more likely to be managed successfully with rehabilitation alone. The choice should be made following specialist assessment and full discussion of the individual's circumstances.
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A Bankart lesion is a tear of the anteroinferior glenoid labrum, the fibrocartilage ring that deepens the shoulder socket. It is the primary structural cause of recurrent anterior shoulder instability. Surgical Bankart repair reattaches the labrum to the glenoid rim using suture anchors.
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A Hill-Sachs lesion is an indentation (impression fracture) on the posterolateral humeral head that occurs when the humeral head impacts against the glenoid rim during anterior dislocation. Large Hill-Sachs lesions can engage with the glenoid rim during shoulder movement and contribute to recurrent instability. They are an important consideration in surgical planning.
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Multidirectional instability is shoulder instability in more than one direction, usually in the absence of significant trauma. It is associated with generalised ligamentous laxity and is more common in young women and overhead athletes. This type of shoulder instability primarily managed with a structured rehabilitation programme and surgery is reserved for cases that fail a thorough course of non-operative management.
Ready to take
the first step?
Book a consultation with Ms Razo and receive a thorough assessment, precise diagnosis and a personal treatment plan.