Shoulder Dislocation and Shoulder Instability

Shoulder Dislocation and Shoulder Instability

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A dislocated shoulder requires immediate care to reposition your shoulder, relieve your pain, look for additional concerns -- such as fracture or tendon, ligament, or labral damage -- and prevent future complications. Our shoulder surgeons work closely with young athletes who suffer shoulder dislocations during sports activities. They also treat older people debilitated by repeated shoulder dislocations and instability that result from years of wear and tear. Our goal is to help you return to your daily activities and optimum sports performance.

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What Is Shoulder Dislocation and Instability?

How Does Shoulder Dislocation Occur?
Falls and hard blows to the shoulder that occur during sports or trauma are the primary triggers for popping the top of your arm bone from the shoulder joint. It’s commonly seen in athletes involved in volleyball, football, soccer, hockey, basketball, wrestling, and rock climbing -- sports that require overhead reaching and stretching. Shoulder dislocation can also occur spontaneously if the connective tissue in the shoulder is naturally loose.

Shoulder Instability Can Result
A shoulder that doesn't heal properly can become weak, unstable, and more likely to dislocate again -- sometimes with everyday movements like rolling over in bed. Shoulder instability can also occur when ligaments are naturally loose, or when they are damaged from repeated motions like throwing a ball, lifting heavy objects, or being hit in the shoulder during sports.

When Surgery Becomes Necessary
Recurrent shoulder dislocations and chronic shoulder instability may be corrected with a surgical procedure.  Your age, activity level, and the extent of your injury will help your shoulder surgeon determine which type of surgery is best for you. Most procedures are performed using an arthroscope, a tiny camera that is inserted through small incisions into the shoulder joint. Shoulder arthroscopy is a minimally invasive procedure that results in less pain. Traditional open surgery, which requires larger incisions, may be necessary for complex shoulder problems.

Our Orthopaedic Clinics
Duke Health orthopaedic clinics are located in Durham, Raleigh, Cary, and locations throughout the Triangle.

When to Seek Care

In severe cases, a dislocated shoulder can damage and even tear the surrounding tendons or ligaments. In most cases, shoulder dislocations are painful and need prompt treatment to reposition the shoulder and prevent ongoing pain as well as future problems.

Same-Day and Next Day Appointments Available
If you need to see an orthopaedic provider right away, many of our clinics have same-day and next-day appointments available.

Visit Duke Orthopaedic Urgent Care 
Our convenient orthopaedic urgent care locations in Durham and near Cary and Morrisville are open seven days a week. Get fast service with no long waits and no unnecessary exposure to sick people.

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Evaluation and Treatments

Comprehensive Evaluation

Your shoulder surgeon will evaluate your condition and use imaging tests, such as X-rays, to look for dislocated joints and fractures of either the ball or socket of the shoulder. An MRI with dye in the joint may be needed to assess damage to the cartilage, tendons, and ligaments of the shoulder joint. Precise maneuvers will return the shoulder to its proper position. Rest, ice, muscle relaxers, and pain medication may reduce pain and swelling.

Physical Therapy

Exercises that strengthen the shoulder muscles are often the mainstay of treatment for some forms of shoulder instability, such as cases where the shoulder ligaments are lax and there was no trauma to the shoulder. This is commonly seen in volleyball players and swimmers. Physical therapy will help you regain strength in your shoulder, relieve your pain, and improve your shoulder function. Duke has physical therapists who specialize in shoulder injuries. They will tailor exercises to help you return to -- and possibly improve -- your sports performance. You will also learn to adopt new habits to reduce your chance of re-injury. 

Bankart Repair

Also known as arthroscopic labral repair, this common procedure repairs tears to the labrum -- the ring of cartilage around the edge of your shoulder socket. It restores stability to shoulders that don’t have extensive damage from repeated dislocations. If there is extensive injury to the labrum or the bone of the socket joint, an open Bankart repair might be recommended.

Remplissage Technique

This arthroscopic procedure repairs a dent in the ball part of the shoulder joint that can result from a dislocated shoulder. This defect can cause the shoulder to dislocate again. This procedure may be combined with the Bankart repair.

Latarjet Technique for Shoulder Instability

The bone at the front of the shoulder socket can become chipped or worn away from repeated dislocations. Your shoulder surgeon may use this technique to transfer a piece of bone and muscles from another part of your shoulder and attach it to the damaged area. Together they keep the ball at the top of your upper-arm bone from slipping out of your shoulder socket. This procedure has proven successful in preventing future dislocations.

Best Orthopaedic Hospital in North Carolina
Where you receive your care matters. Duke University Hospital's nationally ranked orthopaedics program was named the best in North Carolina.
Reviewed: 05/02/2018