What it is
The shoulder trades stability for movement. When the labrum (the rim of cartilage around the socket) is torn, or the socket bone is worn, the ball can slip out of place. In some people the tissues are simply very lax, and in others the muscles around the shoulder blade fire in the wrong order.
How it usually presents
- A history of dislocation or the shoulder partly slipping out
- Apprehension with the arm out to the side and rotated back
- Loss of confidence in sport, swimming or overhead work
How it is assessed
Careful examination to establish the direction and type of instability, X-rays, and usually an MR arthrogram or CT to assess labral and bone loss.
Treatment options
- Structured rehabilitation, which is the first line for muscle patterning instability
- Arthroscopic labral (Bankart) repair
- Bone block procedures such as a Latarjet where there is significant bone loss
Non-surgical treatment is considered first wherever it is reasonable. Which option suits you depends on your symptoms, your goals and what you want from treatment, which is exactly what we discuss in clinic.
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