We often see patients in our office with unexplained shoulder pain. Sometimes we diagnose their condition as shoulder impingement, and sometimes we diagnose their condition as shoulder instability.

Shoulder instability is frustrating, especially when there's no clear cause for it. 

Shoulder instability could be from a recent injury. It could also be from repetitive stress that has been building up over time. 

No matter the cause, shoulder instability can drastically impact your daily life, but chiropractic can help.

What are the symptoms of shoulder instability?

Shoulder instability can manifest as pain, discomfort, and an inability to do everyday activities with ease.

Common symptoms of chronic shoulder instability include:

• Recurrent shoulder dislocations
• Multiple experiences of “your shoulder giving out”
• Feeling like your shoulder is loose, slipping in and out of the joint, or just hanging there
• Extreme pain (less common)

What causes shoulder instability?

Shoulder instability usually happens when the tissue around your shoulder joint gets stretched, torn, or comes loose. 

Shoulder instability is an imbalance or weakness in your shoulder joint, particularly your shoulder girdle, which provides stability and supports the movements of your arm.

Your shoulder girdle is a complex system. It includes the labrum (a type of cartilage holding things together), scapula (shoulder blade), clavicle (collarbone), and the tendons of your rotator cuff muscles. 

When these structures are injured and/or aren't functioning properly, the ball of your shoulder joint can move out of the socket, either completely or partially. 

If your shoulder keeps slipping out of place over and over, we call it chronic shoulder instability.

Shoulder instability can come from a car accident.

A 55-year-old female patient recently came to us for extreme pain in her right shoulder. She had just been in a motor vehicle accident three days prior. 

Her elbows had been locked in extension while holding the steering wheel when the impact occurred. 

Understandably, she was scared and frustrated. She was unsure of why her shoulder hurt so much, because there was no visible evidence of a fracture on her X-rays.

Shoulder instability can come from a FOOSH.

Another patient, an 18-year-old male bicyclist, came in after a fall off his bike. He had fallen on his outstretched hand (also known as FOOSH). 

He was unable to move his shoulder without significant pain. He was even struggling to take his shirt off.

How do chiropractors diagnose shoulder instability?

We first take a detailed patient history, considering factors like your age, overall health, and lifestyle. 

We'll likely ask you about the nature of your pain—is it sharp or dull? Constant or intermittent? Does it radiate to other areas?

We generally assess your ability to move through all active ranges of motion. We'll look at your ability to flex, extend, stretch out, and rotate.

We may perform specific orthopedic tests. The Apprehension Test, Load-Shift Test, and Sulcus Test help us identify instability in your shoulder.

How do chiropractors treat shoulder instability?

The treatment options we choose for your shoulder instability will depend on its root causes. Your treatment plan could include:

• Adjustments to help realign and stabilize your shoulder, and reduce mechanical stress
• Soft tissue therapies like massage, myofascial release, or trigger point therapy to relieve muscle tightness and correct imbalances
• Targeted exercises to build shoulder joint strength and endurance. These exercises can help prevent future dislocations or subluxations, too
• Guidance on proper body mechanics, stretching, and modifications to promote healing and avoid further injury

How long does it take for chiropractic to fix shoulder instability?

Recovery from shoulder instability varies. Your progress will depend on the severity of your condition and your overall health. There are generally four phases that most patients move through:

• Acute Phase (First 2 Weeks): The focus is on reducing pain and inflammation. We may recommend: rest, ice, and shoulder immobilization with a sling. We may also recommend gentle myofascial work
• Subacute Phase (Weeks 2-6): As your pain begins to subside, we'll work on regaining your range of motion with gentle exercises. You may also begin chiropractic treatment or physical therapy during this phase
• Recovery Phase (Week 6 to 3 Months): This is when you should experience significant improvement in pain and stability. That's when we'll introduce progressive strengthening exercises and functional training
• Strengthening Phase (Months 3-6): At this point, you should be ready for advanced strengthening exercises and sport-specific rehab

What's the best self-care for shoulder instability?

Avoiding aggravating activities and strengthening your shoulder muscles helps prevent shoulder instability. That often means making modifications to your routines.

For example, an avid weightlifter would need to substitute bench presses with incline or decline presses. They may also have to use a crossover pulley to reduce the strain on their shoulder.

No matter your favorite activity, we can often help you learn to keep doing activities you love with slight modifications. 

With careful management and chiropractic support, you can regain shoulder stability and reduce pain, returning to your daily activities with confidence.

Are you struggling with shoulder pain?

Schedule an online appointment with our highly-rated chiropractors in Aptos. We can help identify the cause of your shoulder pain and develop a treatment plan that gets you back into life, pain-free.