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Shoulder Instability: Getting Back into the Swing of Things

Whether you are an athlete or not, a lot hinges on your shoulder (get it!?). Jokes aside, you’ll have a hard time lifting a barbell, not to mention picking up your kids, if you have stretched or torn the ligaments or tendons in your shoulder. To learn how to speed up the healing process for an injured or recently operated shoulder, we spoke with Rafael Buerba, MD, an orthopedic surgeon at Banner Health Center plus in Arizona.

What causes shoulder instability?

Shoulder trauma can happen all at once, or the damage can accumulate over time. Baseball pitchers, volleyball players and other overhead athletes are prone to these sorts of injuries caused by repeat motion. Some people are born with ligaments that are looser than others. Signs of hypermobility include ability to touch palms to floor while bending at waist, hyperextension at the knee and elbow, ability to hyperextend the small finger beyond 90 degrees and ability to touch the thumb to the forearm of the same extremity. Hypermobility means that relatively little force is needed to push the shoulder out of socket.

Don’t leave shoulder instability untreated

Dr. Buerba warned against putting off treatment. “The more dislocations/subluxations a patient has, the more the shoulder tissues and bones get damaged. After a single dislocation, the shoulder can usually be stabilized arthroscopically. However, patients with repeat dislocations can wear out the anterior soft tissues and the anterior glenoid bone to the point that the shoulder cannot be stabilized with a simple arthroscopic surgery. These patients may require more complicated open procedures.”

Recurrent injuries lead to bone loss and deterioration of the joint. Open surgeries following repeat dislocations often require screws and other hardware, which can make further treatment difficult in the future.

Is surgery the only option?

Going “under the knife” isn’t your only option if you’ve stretched or even torn the connective tissue in your shoulder. “In fact, if the patient is between 20-40 and is not a competitive athlete, minimal damage may be handled without an operation,” said Dr. Buerba. If the rotator cuff is torn, surgery is likely to be your only option. But don’t worry, reparative shoulder operations are generally extremely successful and will greatly improve your quality of life.

How can a physical therapist speed up recovery?

Physical therapists work with you to strengthen and stabilize your shoulder following injury or surgery. Dr Buerba added, “The work you’ll do with a physical therapist basically strengthens all the muscles of the shoulder joint to help prevent the shoulder from being unstable. It’s vital to your recovery process.”

Regardless of your surgery, total recovery times hover at around 5-6 months. Finding the proper routine is a balance of letting the joint heal while also pushing flexibility and strength training to prevent stiffness. For many patients, the most helpful guidance a physical therapist can give is a customized training schedule that doesn’t push the joint too hard right away.

Preventing reinjury

Reinjury is just around the corner for patients ignoring treatment. For patients on the road to recovery, the risk is lessened but will always be there. Dr. Buerba offered a few tips for people dealing with shoulder instability:

  1. Don’t do it alone – Getting treatment to prevent future injuries is the best thing you can do for the health of your shoulder.
  2. Know your limits – Recover at a safe pace and pay attention to how your joint is feeling. Depending on your rehabilitation, you may need to avoid activities that put you at risk of repeat injury.
  3. Train wisely – Keeping your shoulder strong and flexible is important. Avoiding any and all motion with the joint may feel like playing it safe, but effective recovery includes safe strength training to protect the joint in the future.

Joints in motion, stay in motion. If you are experiencing discomfort in your joints, find a way to keep moving by connecting with a physician and making a plan. Visit to find a Banner Health provider near you.

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