Shoulder Instability & Dislocation Macleod

Shoulder Instability MacleodThe shoulder is the most flexible joint in the body. With this great range of motion comes a vulnerability to instability, subluxation and dislocation.

Dislocation occurs when the ball of the joint is forced out of the socket, most commonly out the front (anteriorly), where the ligaments are weakest. This usually happens as a result of sudden force being applied when the arm is elevated, but can happen without trauma if a person is unusually flexible.

Dislocations can be partial, called a subluxation, which usually spontaneously relocates, or a full dislocation where the ball has completely come out of the socket. This generally will not spontaneously relocate and requires urgent medical assistance. Once a shoulder has dislocated it is vulnerable to repeat episodes. If this occurs it is called chronic instability.

Generally the prognosis for shoulder dislocations managed conservatively is very good. When the shoulder dislocates there will be stretching and / or tearing of some of the ligaments. This may result in ongoing laxity even after full recovery. Factors leading to poorer outcomes include:

  • Previous subluxation / dislocation
  • Significant bony damage altering the shape of the joint surfaces
  • Significant ligament and labral (cartilage) damage
  • Failure to rehabilitate the scapula and rotator cuff stabilising muscles
  • Return to high risk activities too soon.

If conservative management fails, consultation with one of our affiliated shoulder surgeons is recommended, to discuss surgical repair of stability of the joint.

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