Shoulder Instability

A sense the shoulder may “pop out” — in certain positions, especially overhead. Recurrent dislocations or slipping — with progressively less force needed each time. Pain and apprehension — when the arm is raised and rotated outward. A loose or “dead-arm” feeling — during or after activity. Weakness — and reduced confidence in the joint.

A previous traumatic dislocation — the most common cause. Repetitive overhead sport (throwing, swimming, volleyball). Naturally loose ligaments (generalised hypermobility). Young age at first dislocation, which raises recurrence risk.

Specific apprehension and relocation tests reproduce the feeling of instability and localise the direction. An MRI — often with contrast (MR arthrogram) — shows labral tears (such as a Bankart lesion) and any associated bone loss, which is critical for surgical planning.

Rehabilitation: Strengthening the rotator cuff and shoulder-blade muscles improves dynamic stability — a sensible first step for first-time, low-demand cases. Arthroscopic stabilisation: The torn labrum and ligaments are reattached and tightened through keyhole surgery (a Bankart repair) to restore a stable socket. Bone-block procedures: Where there is significant bone loss, a procedure such as the Latarjet rebuilds the socket’s front edge for durable stability. Risk-based: Young athletes in collision sports often benefit from earlier stabilisation, given the high chance of recurrence with rehab alone.

After stabilisation surgery the arm is supported in a sling, followed by a progressive programme that restores motion, then strength, then sport-specific control. Return to contact sport is typically around four to six months and is guided by regained strength and confidence. Modern arthroscopic repair has a high success rate in preventing further dislocations.