My shoulder keeps slipping out

The shoulder is built for an enormous range of movement, which makes it inherently less stable than many other joints.

When it dislocates, the labrum and supporting ligaments may be damaged. In some patients, there can also be damage to the bone of the socket or the ball of the shoulder.

Whether it happens again depends on several factors.

Age at the first dislocation is one of the most important.

A first dislocation in the late teens or early twenties carries a substantially different recurrence risk from a first dislocation later in life.

What we look at

We want to know:

• how old you were at the first dislocation
• how many times it has happened
• what you were doing when it happened
• whether it reduced by itself or needed to be put back
• whether you play contact or collision sport
• whether you do activities that repeatedly place the shoulder in vulnerable positions
• whether there is bone loss or other structural damage

The last point matters particularly.

If there is significant bone loss, a straightforward soft-tissue keyhole repair may not provide enough stability. A different reconstruction may be more appropriate.

What happens if you wait?

Repeated instability can cause further damage to the labrum and, in some patients, the bone.

That can change the type of surgery required later.

We therefore look at your imaging and clinical examination and tell you whether continuing with rehabilitation is reasonable or whether the pattern of instability makes stabilisation more sensible.

When surgery may not be the answer

A first dislocation following an accident, particularly in an older person who does not participate in contact sport, may be managed initially with appropriate rehabilitation.

The aim is to restore movement, strength and control and see whether the shoulder remains stable.

One dislocation does not automatically mean one operation.