Shoulder Instability

Overview

Shoulder instability occurs when the shoulder joint becomes loose or slips out of position. This can range from mild symptoms of the shoulder feeling “loose” to recurrent complete dislocations where the arm bone comes out of the socket.

Instability may develop from a traumatic injury (such as a dislocation from a fall or sports collision) or from repetitive strain with gradual loosening of the joint. Some people experience a single episode, while others have recurrent instability.

When Is It Needed?

Conservative (non-surgical) treatment is usually recommended initially for:

• First-time shoulder dislocations
• Mild instability without recurrent episodes
• Symptoms managed effectively with physiotherapy, bracing and activity modification

Surgery may be considered when:

• Shoulder dislocations recur repeatedly
• Conservative treatment (physiotherapy, bracing) has not prevented further episodes
• You participate in contact sports or overhead activities and instability is limiting performance
• Imaging shows significant bone loss at the glenoid rim (the socket edge)

The Procedure

Shoulder stabilisation surgery aims to restore stability by repairing the damaged structures that hold the shoulder in place.

Arthroscopic Bankart repair is the minimally invasive approach for most patients:

• The torn labrum (cartilage rim) and capsule are repaired using suture anchors
• Performed via small arthroscopic incisions
• Day surgery in most cases
• Less tissue trauma and faster recovery than open surgery

Latarjet procedure may be recommended for patients with significant bone loss:

• This is an open surgical approach
• Bone is transferred to rebuild the glenoid rim and restore stability
• Typically reserved for cases with major bone loss or failed previous repairs

Regardless of approach, Dr Markham will select the technique best suited to your specific anatomy and injury pattern.

Recovery & Rehabilitation

Recovery from shoulder stabilisation surgery requires protection of the repair combined with gradual strengthening.

• 0–6 weeks: A sling is worn to protect the healing repair. Gentle range-of-motion exercises begin within prescribed limits.
• 6 weeks: Sling use is progressively reduced as healing allows. Driving can resume once you are completely out of the sling.
• 3 months: Adherence to post-operative protocol is critical in the first 3 months to protect the repair.
• 6 months: Return to normal sport and overhead activities is typically possible by 6 months, with progression guided by your surgeon and physiotherapist.

Showering is permitted with the waterproof dressing intact. Swelling and discomfort are normal in the first 1–2 weeks.

Risks & Complications

Most shoulder stabilisation procedures achieve lasting stability. However, complications can occur:

Common side effects:

• Pain and discomfort in the first 1–2 weeks
• Swelling and bruising
• Temporary stiffness

Less common complications:

• Recurrent instability (may require revision surgery)
• Nerve injury causing temporary or rarely permanent sensory changes
• Infection
• Limited range of motion if rehabilitation is incomplete
• Reaction to anaesthesia

Following the post-operative protocol carefully—including sling use, activity restrictions and physiotherapy—minimises the risk of recurrent instability.

Frequently Asked Questions

Can I return to contact sports after surgery? Return to contact and overhead sports is typically possible around 6 months after surgery, provided you follow the post-operative protocol carefully. Your surgeon will assess your progress and guide your return to sport.

What if my shoulder dislocates again after surgery? Recurrent dislocation is uncommon following stabilisation surgery if the post-operative protocol is followed. If instability recurs, revision surgery may be required.

When can I start physiotherapy? Gentle range-of-motion exercises begin immediately after surgery within prescribed limits. Progressive strengthening begins around 6 weeks once the sling is removed. Your surgeon and physiotherapist will guide your rehabilitation program.

Will I have full range of motion after surgery? Most patients regain good range of motion, though some may have minor restrictions in certain positions (such as external rotation). Regular physiotherapy helps maximise range of motion.

How soon can I return to work? This depends on your job demands. If your work does not require heavy lifting or overhead activities, you may return to light duties within 2–3 weeks. Heavy or overhead work typically requires 2–3 months before return.