This joint mobility is usually stable and well controlled.
But some people have shoulder joints that are too mobile.
This may make the shoulder more likely to move out of joint.
ADAM GAULT / SPL / Getty Images
When the shoulder does not sit as tightly as it should within the joint, it’s calledshoulder instability.
Overview of Shoulder Instability
The shoulder is a ball-and-socket joint.
Sometimes the ball comes partially out of the socketa condition described as ashoulder subluxation.
And if the ball comes completely out of the socket, this is ashoulder dislocation.
Your doctor may order tests of your shoulder.
Usually, people can recover from multi-directional instabilitywith non-surgical treatments.
This includes high-level, competitive athletes.
Treatment should focus on strengthening the muscles and tendons of the shoulder joint.
This is done with physical therapy.
Multi-directional instability can also happen when the shoulder blade movements are not well-coordinated with the shoulder movements.
Shoulder joint function can improve when you restore normal shoulder blade motion with strengthening exercises.
However, some people don’t improve and may need to have shoulder surgery.
They do this through strengthening exercises.
These exercises gradually improve shoulder blade motion while making the muscles and tendons stronger.
When strengthening exercises don’t work, the doctor may recommend surgery.
Usually, the surgery involves tightening the ligaments that surround the shoulder.
This can be done with arthroscopic surgery or standard surgical incisions.
The best surgery for multi-directional instability is called a capsular shift or capsular plication.
These are procedures that tighten the shoulder capsule, a group of ligaments that surround the ball-and-socket joint.
Thermal shrinkage procedures had very poor results and often required additional surgery.
If you have had thermal shrinkage treatment, you might need surgery if your symptoms return.
People usually receive several months of rehab after surgery for multi-directional instability.
Initially, after surgery, the shoulder is kept from moving to allow the tightened tissues to heal.
For example, the doctor may have you wear a sling.
Then motion is gradually started to regain mobility, followed by strengthening exercises.
Most athletes are allowed to resume full activity within six months.
Summary
Multi-directional instability (MDI) happens when the shoulder joint is loose in the socket.
You may experience pain or instability when reaching overhead.
You may even feel a popping in your shoulder joint.
Sometimes your shoulder may feel like it’s slipping out of its position.
De Martino I, Rodeo SA.The swimmers shoulder: multi-directional instability.Current Reviews in Musculoskeletal Medicine.
2018;11(2):167-171. doi.
Best MJ, Tanaka MJ.Multidirectional instability of the shoulder: treatment options and considerations.Sports Medicine and Arthroscopy Review.
2011;19(12):758-767. doi:10.5435/00124635-201112000-00006
