Shoulder instability is caused when the head of the upper arm bone is forced out of the shoulder socket. Because the shoulder joint is the most mobile joint in our bodies, it is also the joint that is most frequently dislocated. Shoulder instability can develop in a variety of ways:
![Shoulder Instability]( "Shoulder Instability")
Trauma or injury, including labral tears and/or dislocations of the shoulder joint.- Repetitive motion injury, especially among athletes who would make the same overhead motions again and again, causing excessive wear and tear on the shoulder joint (as in baseball, tennis, swimming or volleyball
- Genetic factors, which can cause general looseness in the joint and surrounding ligaments, tendons, and muscles, especially when the shoulder is put under strain or stress.
Trauma or injury, including labral tears and/or dislocations of the shoulder joint.Common Symptoms of Shoulder Instability
- Pain in shoulder caused by injury
- Dislocated shoulders due to sports, vehicular, or other types of injury
- History of shoulder “slipping” in and out of socket
- Acquired shoulder laxity from repetitive activities such as throwing or swimming.
Diagnosing Shoulder Instability
Shoulder instability can be diagnosed with a careful and thorough physical examination. Imaging tests such as x –rays or a magnetic resonance imaging (MRI) help confirm the diagnosis and locate the exact area of injury. MRIs show the soft tissues a bit better than traditional x-rays.
Treatment of Shoulder Instability
Typically shoulder instability is treated with nonsurgical options. If non-operative treatments don’t relieve the pain and instability, surgery is often necessary. If surgery is required to treat shoulder instability, the goal should be to render the shoulder more stable without sacrificing motion. Whenever possible, minimally invasive surgery is done to repair shoulder instability. Minimally invasive arthroscopic surgery is generally less painful, less likely to cause complications, and enables a rapid early recovery process compared to traditional open surgery. Minimally invasive surgery does not require large dissections and splitting muscle layers; as a result the pain from shoulder stabilization surgery is decreased.
The surgery is carried out under general and regional anesthesia. A small fiber optic scope allows the physician to see inside the joint, and instruments are inserted through two small incisions in the joint to repair the ligaments and the labrum. Depending on the severity of the damage inside the shoulder, surgery may involve labral repair, ligament tightening or both.
Recovery from Shoulder Instability
If surgery is required, the patient may need to wear a sling for a few days or weeks. When the sling is removed, the patient will begin physical therapy. The exercises will improve the range of motion and gradually increase the strength in the shoulder. Physical therapy usually lasts 12-16 weeks.
About Spero Karas, M.D.
Dr. Karas joined the Emory Orthopaedic & Spine Center physician team in 2005. Dr. Karas is a recognized expert in the field of shoulder surgery, knee surgery, and sports medicine, and has been awarded numerous grants for research and product development. A frequent speaker throughout the United States and internationally, his work has been featured in Ski Magazine, Men’s Health, and on NBC, FOX, and CNN network television. He is also active in quality musculoskeletal research, and has been honored by his peers with nominations for numerous research awards. He actively collaborates with medical corporations by developing cutting-edge technology to improve the instruments and techniques in orthopedic surgery.
Dr. Karas received his undergraduate degree from the University of Notre Dame, and his Doctor of Medicine degree from Indiana University School of Medicine. After medical school, he completed a residency in Orthopedic Surgery at Duke University Medical Center. After residency, Dr. Karas completed a Knee, Shoulder, and Sports Medicine Fellowship at the prestigious Steadman Hawkins Clinic in Vail, Colorado. While in Colorado, he served as an Associate Team physician for the Denver Broncos and Colorado Rockies professional sports teams.
In addition his role as an Emory Sports Medicine Center physician, he currently serves as the head team physician for the Atlanta Falcons, a consulting team physician for Georgia Tech University, Emory University, Oglethorpe University, Georgia Perimeter College, and Lakeside High School. Prior to this, he served as chief of the Shoulder Service, team physician, and director of the Orthopaedic Sports Medicine Fellowship at the University of North Carolina at Chapel Hill Department of Orthopaedics. Dr. Karas was selected as one of America’s “Top Sports Medicine Specialists” in Men’s Health Magazine. He has also been named one of the “Top Sports Medicine Doctors for Women” by Women’s Health magazine, “Best Orthopaedic Surgeons in America” by Castle Connolly, and the most trusted sports specialist in Atlanta, Georgia by Atlanta Magazine.
Dr. Karas was a varsity letterman in wrestling at the University of Notre Dame and continues to participate in sports such as golf, skiing, snowboarding, and fitness training. He also coaches little league sports, and is an active member of his church and community. Dr. Karas and his wife, Johanna, are blessed with three very active and beautiful children – Gus, Elena, and Nicholas.
