Shoulder Instability

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What is a shoulder instability?

Shoulder instability happens when the upper arm bone (humerus) feels loose in the shoulder socket. Typically, the ball at the top of the humerus fits into the cup-like socket of the shoulder blade, held securely by ligaments, muscles and tendons. When those structures are too loose, the upper arm can move out of place. If the upper arm slips partially out of the socket, it’s called subluxation. If it comes entirely out, it’s considered a dislocated shoulder. 

During a time when bones and joints are still developing, it’s important to watch for signs of pediatric shoulder instability. Getting the proper treatment now can help prevent longer-term problems in adulthood.  

Signs to look for of shoulder instability in children

Many symptoms of shoulder instability are noticeable to others, while some surface by talking with your child. Common signs can include:  

• Shoulder pain, especially when engaging in motions like throwing or serving a ball. 
• Shoulder feeling loose, weak, or, that it might pop out. 
• Numbness and/or tingling in the arm. 
• Limited range of motion with daily activities or sports. 
• Sounds of popping or crunching when moving the arm. 
• Visible swelling or bruising of the shoulder. 

What causes shoulder instability in children?

Kids lead active lives. From playing sports year-round to hanging out with friends after school, every tumble and collision can cause shoulder instability. Common causes include: 

• Repetitive overhead movements like those involved in swimming, baseball, volleyball and gymnastics.  
• Sudden injury from a sports collision or a fall from a bike. 
• Loose joints from conditions like hypermobility, which can make shoulder injuries easier, even with minimal force.  

Once a child has a shoulder injury, they are more likely to have more in the future because the joint becomes weaker. Early diagnosis and specialized treatment help kids stay active throughout childhood and beyond

How is shoulder instability treated?

There are various treatment options for shoulder instability in kids, depending on the severity of the injury and its root cause.  

Non-surgical treatments for shoulder instability: 

• Rest: Eases stress on the shoulder joint.
• Ice: Reduces site swelling and pain. 
•  Anti-Inflammatory Medication: Helps manage pain. 
• Physical Therapy: Improves muscle strength, flexibility, and stability through a specifically designed rehab program. 

Surgical treatments for shoulder instability:

• Arthroscopic Surgery: Utilizes tools called arthroscopes that surgeons insert through small incisions. This allows them to see the joint with minimally invasive techniques.   
• Open Surgery: Accesses the shoulder joint with a single, larger incision to better address the injured area. Orthopedic specialists often recommend open surgery for a recurrent dislocated shoulder, bone grafts, and more severe labrum repair.  

At CHOC, part of Rady Children’s Health, our pediatric specialists develop tailored treatment plans for patients considering factors like age and activity level. We take the time to listen to your concerns and ensure you feel informed and confident as part of your child’s care team.

When to see a pediatric orthopedic specialist for shoulder instability 

While many shoulder injuries seem temporary, you always want peace of mind that your child can lead the healthiest life possible. A pediatric orthopedic specialist can evaluate your child’s condition and recommend the best treatment. You should consider seeing a specialist if: 

• Your child repeatedly has a subluxated or dislocated shoulder.  
• The shoulder visibly looks out of place. 
• Your child has severe pain or difficulty moving their arm. 
• You see swelling, warmth, and redness in the area. 

If you notice any of the above symptoms—or are simply looking for clarity—please don’t hesitate to contact a CHOC orthopedic specialist today.