A loose shoulder, or shoulder instability, is when the ligament that surrounds the joint of the shoulder is unstable and slips in and out of place. The shoulder then goes "out of joint" and can cause shoulder pain, joint instability, and other shoulder problems. Whenever the joint goes in and out of place multiple times, a patient is usually diagnosed with a loose shoulder.
Patients will often have more problems with a shoulder instability issue if they are very athletic or active. Care should be given whenever an activity calls for the hands to be above the head region while moving about, such as while basketball playing. Whenever the shoulder joint moves out of place, it can lead to cartilage damage.
There are two general types of problems that can cause shoulder instability. A person may have a natural loose shoulder that is not caused by any specific trauma or injury, and there are those who have joint instability due to injury. Post-trauma injuries can be particularly painful.
Bankhart lesions are those injuries where the bone has pulled away from the ligament, creating a full tear. This is a very painful condition. Shoulder pain can come from the tear and remain even after it has healed as chronic phantom pain.
Some multidirectional instability can cause three way dislocations and is typically seen in those individuals who are called double jointed. They are flexible and have general joint looseness throughout life. Some individuals are naturally born with this type of shoulder instability; it is not commonly caused through trauma or stress.
A loose shoulder that is seen in very young individuals usually means that they will have more episodes of shoulder instability than those who first experience it later in life. The older an individual is, the less likely he or she is to suffer from a loose shoulder. This is due to the natural stiffening that people get as they age.
Finding the cause of the instability is the first step in treating a loose shoulder. This is done with x-rays, physical exams, and sometimes with magnetic resonance imaging (MRI) scans. Once the cause is found, it can be determined what course of treatment to use and what direction the joint slides out of place.
Some treatments for the condition include surgery, cortisone injections, non-steroidal inflammatory drugs (NSAIDs), and capsular shift. Capsular shift is where the joint pocket is made tighter and smaller, bringing it together with sutures. Tightening the joint pocket can help keep it from sliding out of place.