The shoulder is an amazing, unique structure that is designed to be as mobile as possible. This mobility allows us to throw overhand, perform swim strokes, and move our arms in all the ways we need to in order to participate in our favorite athletic activities. Unfortunately, the same configuration that makes our shoulders so versatile also makes them prone to becoming unstable, and potentially even dislocated.
If your athletic performance and overall quality of life is being affected by shoulder pain, it’s entirely possible that shoulder instability may be the cause. To learn more about this condition and its potential treatment options, read the following frequently-asked questions from Dr. Michael Rytel:
What is Shoulder Instability?
The shoulder is a very complicated structure made up of multiple parts, including a host of ligaments that form the “capsule” of the joint. The ligaments attach to the socket (glenoid) by way of a thin rubbery cartilage structure called the labrum. The shoulder also contains a bony “ball” (the humeral head) which is suspended in the socket by the ligaments and the rotator cuff. Together these components keep the shoulder stable while allowing the tremendous range of motion required for optimal function. However, should any of these tissues become torn, detached, or stretched out of proportion, the ball of your shoulder joint may fail to stay centered in the socket. This is shoulder instability, and should it progress, your shoulder may eventually begin to slide out of the socket. If the ball comes part of the way out of the socket we refer to it as being subluxed, and if it comes completely out of the socket it is dislocated.
How Does Shoulder Instability Happen?
Shoulder instability occurs as a result of either a traumatic injury such as a forceful action during athletics that causes the joint to dislocate (Traumatic Instability), or a gradual stretching of the ligaments over time leading to subluxation (Atraumatic Instability). In fact, 95% of anterior shoulder dislocations occur due to traumatic injuries, half of which were sustained while participating in athletic activities. There are also certain factors that can put you at a greater risk for shoulder instability or dislocation, including:
- Age (15-29 years old)
- Having previously dislocated your shoulder in the past
- Pre-existing weakness in the shoulder muscles
- Certain genetic conditions that compromise your ligaments by making them too loose
- Participation in high-risk sports, such as football (traumatic); volleyball, tennis, baseball, and swimming (atraumatic)
- Gender (men are significantly more likely to suffer from shoulder instability, particularly traumatic
But how do you know if the pain you’re feeling in your shoulder is a result of shoulder instability? The most common symptoms patients report with atraumatic instability include the feeling that their shoulder is coming out of its socket, pain, and apprehension in certain positions. With a traumatic dislocation, pain is sudden and severe, and is followed by the inability to move the shoulder. Subsequently, you may also experience swelling and bruising in your affected shoulder. Dr. Rytel will use your history along with an examination of your shoulder to help determine if your symptoms are from instability.
What Are the Best Treatments for Shoulder Instability?
Dr. Rytel always recommends the least invasive, most conservative treatment whenever possible for his patients, and those struggling with shoulder instability are no exception. Fortunately, many cases of shoulder instability can be treated non-surgically with a combination of targeted physical therapy, activity modification and pain management. Following a traumatic dislocation, you may also be asked to wear a sling or brace as your shoulder heals.
That said, some patients have such extensive or repetitive injuries that shoulder surgery becomes necessary to make an effective, long-term recovery and restore their full range of motion. During a surgical procedure to correct shoulder instability, Dr. Rytel will insert a small camera known as an arthroscope into your shoulder, allowing him to view the entirety of your joint on a screen without invasively opening the area. Then, he will repair the damaged tissues with sutures as necessitated by the nature of your injury. In some cases, Dr. Rytel will need to insert anchors into the bone in order to permanently stabilize the joint and ensure that your shoulder doesn’t become unstable again.
How Long is the Typical Shoulder Instability Surgery Recovery Time?
As is the case with any procedure, the time you’ll spend in recovery depends largely on the nature of your injury and the type of surgery that was performed. However, according to Johns Hopkins Medicine, the standard recovery period for shoulder instability surgery proceeds as follows:
- 3-7 days after surgery to eat and write
- 1-4 weeks to begin physical therapy
- 6-8 weeks for a return to full range of motion
- 3 months to return to full strength
- 6 months to return to full sports activity
It’s important to remember that your body and your circumstances are unique, and multiple factors will affect the exact timing of your recovery. While planning your treatment, Dr. Rytel will indicate these factors to you and discuss the best way to move forward in order to reach your goals of returning to the sport you love.
Don’t forget that physical therapy is not optional! If your personal goals involve a full return to your peak athletic performance, it’s imperative that you complete all of the physical therapy sessions recommended to you by Dr. Rytel and remain diligent about rebuilding your strength and range of motion throughout your recovery period. Our team is here to help and support you at every step of the way!
Dr. Michael Rytel is highly experienced in performing shoulder instability repair surgery and other minimally-invasive, cutting-edge orthopedic procedures. If you’re struggling with a shoulder injury, don’t hesitate to reach out or schedule an appointment online using our simple form!