Understanding a shoulder that feels loose, unstable or “out of place”
The shoulder is one of the most mobile joints in the body. This allows us to reach, throw, lift and move our arm in many directions.
However, this mobility also means the shoulder can become unstable or dislocated.
What is shoulder instability or dislocation?
The shoulder is a ball-and-socket joint.
The ball at the top of your upper-arm bone sits in a relatively shallow socket in the shoulder blade.
The joint is supported by:
- Ligaments
- The labrum
- Rotator cuff muscles
- Other muscles around the shoulder blade
Shoulder Instability
Instability means the shoulder does not feel as securely controlled as it should.
You may feel that the shoulder is:
- Slipping
- Moving too far
- Giving way
- About to come out of place
Shoulder Dislocation
A dislocation occurs when the ball comes completely out of the socket.
A partial slip is called a subluxation.
A dislocation is a medical injury and should be assessed and treated promptly.
What are the symptoms?
Symptoms can include:
- Shoulder pain
- A feeling that the shoulder is slipping
- Repeated episodes of giving way
- Clicking or catching
- Fear when moving the arm into certain positions
- Reduced confidence using the shoulder
- Weakness
- Reduced movement after an injury
- A visible change in shoulder shape during a dislocation
After a dislocation, the shoulder may remain painful and weak even after it has been put back into position.
What causes shoulder instability or dislocation?
- A. Trauma, fall, collision or sporting injury
Trauma, a fall, collision or sporting injury can force the shoulder out of its normal position.
- B. Previous dislocation
Once a shoulder has dislocated, some people become more vulnerable to future episodes.
- C. Ligament or labral injury
A dislocation can damage structures that normally help stabilise the shoulder.
- D. General joint looseness
Some people naturally have more flexible joints and may be more prone to instability.
- E. Repetitive overhead activity
Certain sports and activities repeatedly place the shoulder in positions where instability can occur.
When should you see a physiotherapist?
Physiotherapy is particularly important after a shoulder dislocation once the shoulder has been medically assessed and the appropriate initial protection period has been completed.
See a physiotherapist if you experience:
- Repeated shoulder instability
- A feeling of the shoulder slipping
- Weakness following dislocation
- Fear of certain shoulder movements
- Difficulty returning to sport
- Reduced shoulder strength or movement
- Recurrent subluxation
Important to Note
If you think your shoulder is currently dislocated, do not try to put it back yourself.
Seek urgent medical attention.
Numbness, severe weakness, loss of circulation or significant trauma also require prompt medical assessment.
How is it treated?
At Elevate, we tailor-make a complete “Road Map” based on the patient’s biopsychosocial status, keeping in mind their concerns and goals to return to the activities they enjoy the most.
Treatment depends on the severity and cause.
It may include:
- Initial medical assessment
- Protection/immobilisation when appropriate
- Pain management
- Physiotherapy
- Rotator cuff strengthening
- Shoulder blade strengthening
- Proprioception and control exercises
- Stability training
- Gradual return to sport
Some patients with repeated instability or significant structural damage may require an orthopaedic assessment and potentially surgery.
What is the treatment process like?
Stage 1 — Protect the Shoulder
After a dislocation, the initial priority is protecting the injured structures and allowing pain to settle.
Stage 2 — Restore Movement
Movement is gradually restored according to the injury and medical advice.
Stage 3 — Build Strength
The rotator cuff and other stabilising muscles are strengthened.
Stage 4 — Improve Control
Exercises challenge the shoulder’s ability to remain stable during movement.
Stage 5 — Return to Activity
Sport- and work-specific movements are gradually introduced.
The programme is especially important for people who want to return to throwing, racquet sports, swimming, gym training or contact sports.
What is the treatment process like?
Recovery depends on the severity of the injury, whether there is associated damage and whether surgery is required.
A straightforward dislocation may require several weeks to months before full function and confidence return.
Surgical stabilisation generally requires a longer rehabilitation period.
Evidence at a Glance
Recurrence after shoulder dislocation is strongly influenced by age and other factors. In a large nationwide study, the overall redislocation rate after a first dislocation was 9.4% at one year, 12.7% at two years and 17% at five years. Younger patients had a higher risk.
This is why rehabilitation and an appropriate return-to-sport plan are important after a first dislocation.
The Good News Is
A dislocated shoulder does not mean you have to live with an unstable shoulder.
With appropriate rehabilitation, the aim is to restore:
Strength + stability + movement + confidence Protect → Restore movement → Strengthen → Improve stability → Return to activity
This information is for general education and does not replace an individual assessment by a physiotherapist or doctor.