SHOULDER INSTABILITY

What is shoulder instability?

Shoulder instability refers to a chronic disorder characterised by recurrent shoulder dislocations. Shoulder instability occurs as a result of a loose shoulder joint that glides lazily within the socket. Sometimes, an unstable shoulder can shift out of the socket. As a result, the displacement of the shoulder may be partial or complete.

What causes shoulder instability?

Shoulder instability occurs due to a sudden injury, repetitive use of the shoulder or a pattern of movements affecting the health and durability of the joint. In addition, shoulder instability develops when the shoulder joint’s lining (ligaments, capsule and labrum) detaches or becomes overly stretched.

What are the symptoms of shoulder instability?

• Repeated shoulder dislocations – The shoulder frequently slips out of place.
• Persistent shoulder pain – Ongoing discomfort during movement or activity.
• A loose or unstable feeling – The shoulder may feel weak or as if it could “give way.”
• Clicking or popping sensations – Noises or sensations during shoulder movement.
• Reduced shoulder strength – Difficulty lifting or carrying objects.
• Limited range of motion – Restricted shoulder movement and flexibility.
• Swelling or tenderness – Inflammation around the
• Pinching sensation in the shoulder – A feeling that something is catching or pinching inside the joint.
• Weakness during overhead activities – Difficulty reaching or lifting above shoulder level.

How does Dr van Niekerk check for shoulder instability?

Dr van Niekerk carries out a physical assessment, which involves examining the shoulder in detail. In addition to examining you, Dr van Niekerk enquires about your symptoms and medical history to determine whether a history of bone or joint disease runs in the family.

How do you treat shoulder instability?

Conservative Treatment for Shoulder Instability
Mild to moderate shoulder instability can often be managed without surgery.

Non-Surgical Treatment Options:

• Physiotherapy – Strengthening the rotator cuff and shoulder blade muscles.
• Activity modification – Avoiding movements that trigger instability.
• Rest and recovery – Allowing the shoulder joint to heal properly.
• Pain and inflammation management – Ice therapy and anti-inflammatory medication.
• Shoulder strengthening exercises – Improving joint stability and control.

The goal of conservative treatment is to restore shoulder strength, improve stability, and reduce the risk of future dislocations.

Surgical Treatment for Shoulder Instability

Surgery may be necessary when:

• Non-surgical treatments fail to relieve symptoms
• Recurrent shoulder dislocations occur
• There is a significant rotator cuff or labrum tear
• An acute fracture affects shoulder stability

Arthroscopic Shoulder Surgery (Keyhole Surgery)
Arthroscopic surgery uses small incisions and specialized instruments to repair damaged structures within the shoulder joint.

Bankart Repair
A Bankart repair is commonly performed for recurrent shoulder dislocations. The procedure reattaches torn ligaments and damaged labrum cartilage to restore shoulder stability and function.

Capsulorrhaphy
Capsulorrhaphy tightens and strengthens the shoulder capsule, helping stabilize the ball-and-socket joint and reduce excessive movement.

Latarjet Procedure
The Latarjet procedure uses a bone graft along with healthy muscles and tendons to improve shoulder stability. This procedure is often recommended for severe or recurrent shoulder instability.

Depending on the severity and type of instability, Dr van Niekerk may recommend either a Bankart repair or Latarjet procedure.