A Guide to Shoulder Dislocation and Instability with Dr. Ian Byram

Originally published in the Williamson Source

Dr. Ian Byram is a shoulder and elbow expert at Bone and Joint Institute of Tennessee. He also leads the Research and Outcomes Committee to maintain research and education and ensure Bone and Joint Institute remains at the forefront of orthopedic medicine.

Dr. Byram shares his perspective on shoulder dislocation and instability, including ways to treat and care for the body after suffering a dislocation.

What is Shoulder Dislocation?

The shoulder is a ball and socket joint, which means that the ball – the humerus or upper arm bone – fits into the socket – the scapula or shoulder blade. The shoulder is unique in that the socket is very shallow, unlike your hip which has a very deep socket. Your shoulder requires intact ligaments, tendons and soft tissues for it to function properly and remain stable.

Shoulder dislocation takes place when the ball and socket are no longer in alignment. This typically happens during a fall when a person stretches their arm to try and brace themselves on impact, but it can also happen during other events like seizures. Additionally, if someone is loose-jointed, sometimes the ball may slip out of its socket without any impact.

Who is Most Susceptible to Shoulder Dislocation?

Anyone can dislocate their shoulder. However, it is more common in young people because their bones are stronger, making them less likely to fracture and more likely to dislocate. Athletes are a population Bone and Joint Institute regularly treats for shoulder dislocation.

What Are Some Treatments for Shoulder Dislocation?

Sometimes after a dislocation, the Bone and Joint Institute team treats the injury non-surgically with a period of rest to allow time for the tissue to heal. Then they do physical therapy to strengthen the muscles around the joint to help provide stability. If that fails or if someone has multiple dislocations, medical professionals tend to recommend surgery to fix torn tissue and tighten the area around the joint.

If a patient needs surgical treatment, the Bone and Joint Institute team often recommends minimally-invasive arthroscopic procedures. But in some more severe cases, patients might require open procedures and even bone grafting of the socket. In older patients with arthritis, a shoulder replacement might provide the best long-term relief.

The best way to avoid shoulder dislocation and instability is to maintain good shoulder strength and rotator cuff conditioning.

What Does It Mean When Someone Says “Shoulder Instability”?

Shoulder instability is just another term for dislocation. It means that the ball is not centered or stable on the socket.

People can suffer traumatic dislocations or non-traumatic instability of the shoulder. Non-traumatic instability is when someone is loose-jointed and has increased laxity of their ligaments. Those people can slip their shoulders in and out of the socket without trauma. This is referred to as multidirectional instability.

Because individuals with multidirectional shoulder instability are more likely to dislocate their shoulder with relative ease, they often benefit most from non-surgical treatment, including physical therapy.

What Are the Potential Long-Term Issues with Shoulder Dislocation and Instability?

Every time you dislocate your shoulder, there is a risk of damaging cartilage that lines the ball and socket. Repetitive dislocations can therefore lead to repetitive damage to that cartilage, which can lead to the progression of arthritis. If you have repetitive dislocations, it can also lead to loss of bone on the socket side. If you have bone loss, the way the Bone and Joint Institute team would treat that patient varies depending on individual factors.

If you’ve suffered a shoulder dislocation or have concerns about the stability of your shoulder, schedule an appointment with Bone and Joint Institute.