Do you ever feel like your shoulder is about to “pop out” or “give way”? Have you experienced a shoulder dislocation, where the ball of your upper arm bone (the humerus) comes out of the shoulder socket (glenoid)? If so, you may be dealing with shoulder instability, a condition where the structures that hold your shoulder joint together are not working correctly.
When this happens, it’s not just painful, but it can also make it difficult to do everyday activities, from reaching for something on a high shelf to playing your favorite sport. The good news is that there’s a minimally-invasive surgical procedure that can help: arthroscopic shoulder instability surgery.
Here at California Pacific Orthopaedics, our team of board-certified orthopedic surgeons in San Francisco has extensive experience in diagnosing and treating shoulder instability. We use the latest arthroscopic techniques to repair and tighten the shoulder joint, helping you get back to a life without pain and instability.
Common Symptoms and Causes
Shoulder instability can be caused by a sudden injury, like a fall or a direct blow to the shoulder, or it can develop over time due to repetitive overhead motions, like those in swimming, tennis, or volleyball. Some people are also born with looser ligaments, making them more prone to this condition.
No matter the cause, the symptoms of shoulder instability are often similar and can include:
- A feeling of looseness or instability in the shoulder. It might feel like your shoulder is “slipping” or “shifting” in the joint.
- Pain with certain movements, especially when raising your arm overhead or reaching behind you.
- Clicking, popping, or grinding sensations in the shoulder joint.
- Weakness or loss of strength in the affected arm.
- Numbness or tingling that radiates down your arm.
If you are experiencing any of these symptoms, it’s important to see a doctor to get an accurate diagnosis. Left untreated, shoulder instability can lead to further damage to the shoulder joint, including cartilage tears and arthritis.
Common Risk Factors
While shoulder instability can happen to anyone, there are certain factors that can increase your risk, including:
- Previous shoulder dislocation: If you’ve dislocated your shoulder once, you are more likely to experience it again.
- Age: Young athletes, especially those under the age of 20, have a higher risk of recurrent shoulder instability.
- Sports participation: Athletes who play contact sports (like football or hockey) or sports that involve repetitive overhead motions (like baseball or swimming) are at a higher risk.
- Genetics: Some people are born with naturally looser ligaments, a condition called hypermobility, which can make them more prone to shoulder instability.
- Occupation: Certain jobs that require repetitive overhead work can also increase your risk.
Why a Procedure is Done
The main goal of arthroscopic shoulder instability surgery is to restore stability to the shoulder joint and prevent future dislocations. This is done by repairing any torn ligaments, the labrum, or cartilage and tightening the stretched-out shoulder capsule.
While non-surgical treatments like physical therapy and activity modification can be effective for some people, surgery may be recommended if:
- You have experienced multiple shoulder dislocations.
- Your shoulder instability is causing significant pain and interfering with your daily activities.
- You are a young, active individual who wants to return to high-level sports or activities.
At California Pacific Orthopaedics, our surgeons will work with you to determine if arthroscopic surgery is the right treatment option for your specific needs and goals.
What to Expect Before, During, and After the Procedure
Before the Procedure
Before your surgery, you will have a consultation with one of our orthopedic surgeons. During this visit, your doctor will review your medical history, perform a physical examination, and may order imaging tests like an X-ray or MRI to get a better look at your shoulder joint. This will help them to confirm the diagnosis and plan the best course of treatment.
You will also receive instructions on how to prepare for your surgery, which may include:
- Stopping certain medications, such as blood thinners.
- Arranging for someone to drive you home after the procedure.
- Fasting for a certain period of time before your surgery.
During the Procedure
Arthroscopic shoulder instability surgery is a minimally-invasive procedure, which means it is performed through small incisions, typically about the size of a buttonhole. This results in less pain, less scarring, and a faster recovery compared to traditional open surgery.
During the procedure, your surgeon will:
- Make a few small incisions around your shoulder.
- Insert a tiny camera, called an arthroscope, into one of the incisions. This allows them to see the inside of your shoulder joint on a video monitor.
- Use small, specialized instruments to repair any torn ligaments, the labrum, or cartilage and tighten the shoulder capsule.
- Close the incisions with stitches or small bandages.
The entire procedure usually takes between one and two hours, and you will be able to go home the same day.
After the Procedure
After your surgery, you will need to wear a sling to protect your shoulder and allow it to heal. You will also be given pain medication to help manage any discomfort.
Physical therapy is a crucial part of the recovery process. Your physical therapist will work with you to:
- Reduce pain and swelling.
- Improve your range of motion.
- Strengthen the muscles around your shoulder.
The recovery time for arthroscopic shoulder instability surgery varies from person to person, but most people are able to return to their normal activities within a few months. Your surgeon and physical therapist will provide you with a detailed rehabilitation plan to help you get back to the activities you love as quickly and safely as possible.
