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Shoulder Instability

Instability in the shoulder can be the result of repeated dislocation or subluxation of the shoulder joint (glenohumeral joint). The shoulder may dislocate when the labrum and/or the capsule ligaments tear or become damaged.

Subluxation is where the joint moves more than it should, but doesn’t actually dislocate. There are two types of instability in the shoulder:

1. Instability from hypermobility
Hypermobility is where the shoulder is naturally overly mobile, which can be part of a hypermobility syndrome. Hypermobility is not associated with any trauma. The instability is multi-directional, it involves both shoulders and indeed can involve other joints.

2. Traumatic instability
This is where the shoulder becomes unstable following injury, such as a dislocation or a tear in the glenoid labrum. This involves just the injured shoulder. Most dislocations are anterior - i.e. the humerus bone is pushed forward.

Instability is problematic, as it will inhibit activities that involve a risk of further subluxation or dislocation. This obviously is a big problem for athletes such as tennis players, or anyone whose work involves lifting their arms over the head.

If the shoulder dislocates or subluxates frequently there is a risk that the surface cartilage of the joint can be damaged. Instability can also affect the AC joint, in particular after a dislocation.

Keeping the shoulder muscles strong and being sure to warm up properly before sports and activities will help to keep the shoulder stable and avoid dislocation and subluxation of the shoulder.

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