SHOULDER INSTABILITY

What is shoulder instability?

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.

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 inquires 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?

Treatment for shoulder instability consists of conservative and surgical remedies and physiotherapy, aiming to stabilise the shoulder by increasing the strength of the shoulder blade and rotator cuff muscles.

Normally, surgery is carried out to repair an extensive tear in the rotator cuff and labrum or an acute fracture. Arthroscopic surgery (keyhole surgery) is a means of repairing the shoulder through much smaller incisions. However, surgical intervention is required when non-surgical methods fail to relieve throbbing shoulder pain due to a large, complete rotator cuff tear.

Additional surgical procedures are done to reinforce the shoulder, such as:

• Bankart repair is a procedure to address shoulder dislocations that occur repetitively. The procedure involves reattaching torn ligaments and labrum cartilage in a fixed position to help restore the shoulder’s function.
• Capsulorrhaphy tightens and strengthens the shoulder capsule (the connective tissue surrounding the shoulder), stabilising the ball-and-socket portion of the joint.
• Latarjet procedure is surgery that involves the use of a bone graft and the transfer of healthy muscles and tendons. Depending on the type of shoulder instability you have sustained, Dr van Niekerk may decide to perform the Latarjet procedure or Bankart repair.