A ball and socket joint, the shoulder allows for a variety of movements. The socket of the shoulder bears similarities to that of a saucer rather than a cup. Due to the shallowness of the socket, muscles, ligaments, and cartilage must protect the joint and hold the joint together and in place.
Loose Shoulder, or shoulder instability, occurs when the tissues surrounding the shoulder joint stretch or tear, resulting in the ball of the humerus frequently dislocating from the shoulder socket. The humeral head may either partially, subluxation, or completely dislocate from the socket
Causes of Loose Shoulder
While the causes of Loose Shoulder may vary, the most common causes include:
Symptoms of Loose Shoulder
Patients experiencing Loose Shoulder often report that the shoulder “gives way”. When the shoulder gives way, shoulder pain often accompanies it. Specific motions or positions may exacerbate these symptoms. Decreased range of motion, swelling, and bruising often accompany Loose Shoulder or Shoulder Instability.
How to Diagnose Loose Shoulder
To diagnose a Loose Shoulder, a shoulder physician first conducts a physical examination. In a physical examination, the doctors moves the joint around, asks about family and genetic history, and patient history. If the doctor suspects Loose Shoulder, they order an XRay and potentially an MRI or CT.
How to treat Loose Shoulder
In patients with Loose Shoulder following a traumatic dislocation, a doctor may provide a sling to allow the joint to rest. Doctors suggest Nonsteroidal Anti-Inflammatory Drugs and Ice to keep swelling and pain at bay. The treating physician may prescribe a physical therapy protocol to strengthen the surrounding tissues to prevent further subluxations and dislocations.
If activity modifications and rest does not work, the treating physician may recommend surgery. Physicians may also recommend surgery for patients experiencing instability during sleep, routine activities, work, or recreational sports. To perform the surgery, the surgeon must determine what is causing the instability.
An anesthesiologist places the patient under general anesthesia and the surgeon assesses the shoulder. If the patient exhibits mild instability, the surgeon can perform the surgery arthroscopically. For severe instability, the surgeon may have to perform open surgery, making an incision over the shoulder and moving the surrounding tissue to gain access to the joint. Once the surgeon gains access, they can view the labrum, ligaments, and capsule. Depending on the cause of the instability, the surgeon repairs, reattaches, or tightens the structures. Sutures or anchors hold together any adjusted ligaments.
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