What’s associated with shoulder instability?

In this video, Dr. Grant H. Garcia breaks down what patients should expect during a medical evaluation for shoulder instability and explains the key anatomical factors associated with shoulder dislocations.

Here is a summary of the core points covered:

• Seeking Specialized Care: Dr. Garcia recommends that if you have experienced a first- or second-time shoulder dislocation, you should be evaluated by an orthopedic surgeon specifically trained in sports medicine and shoulder conditions.
• The Clinical Evaluation: During your visit, the surgeon will physically examine the shoulder to check for "apprehension"—a physical sensation or anxiety from the patient that the shoulder is actively about to pop out of place during certain movements.
• Imaging and Bone Damage: X-rays are used to check joint stability and identify structural changes from the injury:
  • Bone Chipping: The surgeon looks to see if any pieces of bone are missing or broken off from the socket.
  • Hill-Sachs Lesion: When a shoulder dislocates out of the front, the impact can create a dent in the back of the humeral head (the ball of the joint). Dr. Garcia notes that the larger this dent is, the higher the risk that the shoulder will continue to pop out of place in the future.
• Age and the Rotator Cuff: The evaluation also heavily considers the patient's age:
  • Under 40 Years Old: The rotator cuff is typically intact, so the clinical focus is predominantly on assessing labral tissue damage and checking for bone dents.
  • Over 40 Years Old: A dislocation carries a much higher risk of tearing the rotator cuff alongside damaging the labrum. This combination creates a more complex and tricky medical situation that requires careful checking.