Shoulder Instability Treatment Options

Shoulder instability is a condition that develops most often as a result of a shoulder dislocation. When the ball of the upper arm bone comes out of the socket, the surrounding ligaments, cartilage, and muscles can become stretched or torn. This initial dislocation weakens the stabilizing structures of the joint, making it more likely that the shoulder will slip, feel loose, or dislocate again in the future.

Because the shoulder joint has the greatest range of motion of any joint in the body, it is especially vulnerable to instability. Athletes who participate in contact sports or repetitive overhead activities are particularly at risk, as the demands of their sports increase stress on the joint.

Dr. Brian Waterman, a board-certified orthopedic surgeon specializing in sports medicine, cartilage restoration, and shoulder and elbow care, offers advanced diagnostic and treatment options for patients with shoulder instability. His expertise ensures that each patient receives a personalized plan designed to restore function, stability, and long-term joint health.

Early evaluation and treatment are important because untreated instability can increase the risk of further dislocations, cartilage damage, and eventual arthritis.

What are the non-surgical treatment options?

In many cases, especially for patients with mild symptoms or first-time dislocations, non-surgical management can effectively restore shoulder stability.

Rest and activity modification

Following an initial dislocation, the shoulder often requires a period of rest to allow swelling and inflammation to decrease. Patients may be advised to temporarily avoid sports or activities that place stress on the shoulder, particularly overhead or contact activities.

Immobilization

A sling or brace may be used for a short period of time to keep the shoulder in position and reduce stress on healing tissues. The length of immobilization depends on the severity of the injury and the patient’s age and activity level.

Physical therapy

Rehabilitation is a cornerstone of non-surgical care. A structured physical therapy program focuses on strengthening the rotator cuff muscles, which help stabilize the ball within the socket, improving the function of the scapular stabilizers, restoring flexibility and range of motion without overstretching healing tissues, and training patients in safe movement patterns to reduce the risk of future dislocations.

Medications and injections

Anti-inflammatory medications may be recommended to manage pain and swelling. In some cases, corticosteroid injections can help decrease inflammation, making it easier to participate in physical therapy and daily activities.

Non-surgical treatment is often most successful in older patients, those with lower activity levels, or individuals with less severe instability. For younger athletes and patients with recurrent dislocations, surgical options may be necessary to achieve lasting stability.

What are the surgical treatment options?

When shoulder instability persists despite rehabilitation, or when the supporting structures are significantly torn or stretched, surgery may be recommended. Dr. Waterman specializes in advanced minimally invasive and open surgical techniques to restore stability while preserving shoulder function.

Arthroscopic shoulder stabilization

This minimally invasive procedure uses a small camera and specialized instruments inserted through tiny incisions. The surgeon repairs and tightens the ligaments and labrum, which is the cartilage rim that deepens the socket of the shoulder. Arthroscopic stabilization offers benefits such as smaller incisions, less postoperative pain, and quicker recovery compared to traditional open surgery.

Bankart repair

A Bankart lesion occurs when the labrum at the front of the shoulder socket is torn during a dislocation. Arthroscopic or open Bankart repair involves reattaching the torn labrum and tightening the capsule to restore stability. This procedure is commonly performed in young athletes and active patients with recurrent anterior dislocations.

Latarjet procedure

For patients with significant bone loss in the shoulder socket or repeated failed repairs, the Latarjet procedure may be recommended. This surgery transfers a small piece of bone with an attached tendon from the shoulder blade to the front of the socket, reinforcing stability. The procedure provides both a bony block to prevent further dislocation and muscular support from the transferred tendon.

Remplissage procedure

In cases where the humeral head—the ball of the shoulder—has developed a dent or “Hill-Sachs lesion” from repeated dislocations, the remplissage procedure may be combined with arthroscopic stabilization. This technique fills in the defect with tissue from the rotator cuff, reducing the risk of the ball slipping out of the socket.

Open stabilization procedures

While many instability surgeries can be performed arthroscopically, certain complex or revision cases may require open surgery. Open procedures allow the surgeon to directly access the joint, repair damaged structures, and restore stability in situations where minimally invasive surgery may not provide sufficient strength.

Recovery and rehabilitation

Recovery after shoulder stabilization surgery is a gradual process. Patients typically wear a sling for several weeks to protect the repair, followed by a structured rehabilitation program supervised by a physical therapist.

The early phase focuses on protecting the repair, controlling pain, and maintaining mobility in the elbow, wrist, and hand. The intermediate phase gradually restores shoulder range of motion and introduces gentle strengthening exercises. In the advanced phase, strengthening of the rotator cuff and scapular muscles is increased, along with functional exercises tailored to the patient’s activities. Athletes may begin sport-specific drills once strength and stability have returned, with full return to competition typically taking several months.

Dr. Waterman works closely with patients to ensure that recovery is safe, personalized, and designed to support long-term shoulder health.

With appropriate treatment, most patients with shoulder instability can return to their desired level of activity. Non-surgical care may be sufficient for some, while others benefit from advanced surgical procedures that restore strength and stability.

Through his specialized expertise in sports medicine and shoulder reconstruction, Dr. Brian Waterman provides patients with comprehensive care—from conservative rehabilitation to cutting-edge surgical solutions. His goal is to help each patient regain confidence in their shoulder, prevent future dislocations, and return to an active, pain-free lifestyle.