Shoulder Dislocation and Instability Treatment in Louisville, KY
Expert Shoulder Dislocation and Instability Treatment From a Fellowship-Trained Shoulder Surgeon
The shoulder is the most mobile joint in the human body, and that mobility comes at a cost: it is also the most commonly dislocated joint. A shoulder dislocation occurs when the ball of the upper arm bone (humerus) is forced out of the shoulder socket, most often by a traumatic fall, collision, or forceful twisting. For many patients, a first-time dislocation is a one-time event that heals with appropriate care. For others, especially younger athletes, a single dislocation is the beginning of a pattern of recurrent instability that significantly affects their quality of life and ability to stay active.
Dr. Nyagon Duany is a fellowship-trained orthopedic surgeon in Louisville, KY, with dual training in sports medicine and total joint replacement. She is experienced in treating the full spectrum of shoulder instability, from acute first-time dislocations to chronic instability requiring surgical stabilization. Having been a competitive Division I athlete and experienced shoulder surgery herself, Dr. Duany brings both technical expertise and genuine empathy to every patient she treats. She will take the time to understand your goals, explain your options clearly, and develop a care plan that gives you the best possible chance of returning to the activities you love.
If you have experienced a shoulder dislocation or are dealing with a shoulder that repeatedly feels like it is slipping out of place, use our online form to request an appointment with Dr. Duany today.
Shoulder Dislocation and Instability: Types, Symptoms & Treatment Options
Understanding Shoulder Dislocation and Instability
Shoulder instability exists on a spectrum. At one end is a single traumatic dislocation with no prior history; at the other is multidirectional instability, in which the shoulder slips in multiple directions due to generalized ligamentous laxity. Understanding where a patient falls on that spectrum is essential to determining the right course of treatment.
Types of Shoulder Dislocation
Shoulder dislocations are classified by the direction in which the humeral head displaces:
- Anterior dislocation is by far the most common type, accounting for the vast majority of cases; it occurs when the arm is forced backward in an abducted, externally rotated position and the humeral head is pushed forward out of the socket
- Posterior dislocation is less common and is typically caused by a direct blow to the front of the shoulder, a seizure, or an electrical shock
- Inferior dislocation (luxatio erecta) is rare and involves downward displacement of the humeral head; it is usually associated with significant soft tissue injury
What Causes Shoulder Instability?
Shoulder instability can develop from several different mechanisms:
- Traumatic instability results from a single high-energy event such as a dislocation; this often damages the anterior labrum (Bankart lesion) and the ligaments that stabilize the front of the shoulder
- Atraumatic instability occurs without a specific injury event and is associated with generalized joint laxity or hypermobility
- Recurrent instability develops when the structural damage from an initial dislocation is not adequately repaired, allowing repeated episodes of subluxation or dislocation
Patients who sustain a first-time dislocation at a young age are at particularly high risk for recurrence, with studies suggesting that young athletes who dislocate their shoulder have a recurrence rate as high as 80 to 90 percent without surgical stabilization.
Shoulder Instability Symptoms
Common shoulder instability symptoms include:
- A feeling that the shoulder is "loose," slipping, or about to come out of place
- Recurring episodes of subluxation (partial dislocation) or full dislocation
- Apprehension or guarding when the arm is raised and rotated outward
- Pain with overhead activity or certain arm positions
- Weakness and decreased confidence in the shoulder during sport or daily activity
- A sensation of "dead arm" in which the arm temporarily goes numb or weak during activity
Shoulder Dislocation and Instability Treatment Options
Treatment depends on the type and severity of instability, the patient's age and activity level, and the extent of structural damage present.
Conservative treatment is appropriate for first-time dislocations in older or less active patients and for cases of atraumatic instability, and may include:
- A period of immobilization in a sling following an acute dislocation
- Anti-inflammatory medications to manage pain and swelling during the acute phase
- Physical therapy focused on strengthening the rotator cuff and periscapular muscles to improve dynamic shoulder stability
- Activity modification to reduce the risk of further episodes during recovery
Surgical treatment is typically recommended for younger patients with a first-time traumatic dislocation, patients with recurrent instability, and those with significant structural damage identified on imaging. Dr. Duany performs arthroscopic Bankart repair in which the torn anterior labrum is reattached to the glenoid rim to restore shoulder stability. For patients with significant bone loss from the glenoid or humeral head, a more complex bony stabilization procedure, such as a Latarjet procedure, may be indicated.
Frequently Asked Questions
What are the symptoms of shoulder instability?
Common shoulder instability symptoms include:
- A feeling that the shoulder is slipping, loose, or about to dislocate
- Repeated episodes of the shoulder coming partially or fully out of place
- Apprehension when raising and rotating the arm outward
- A "dead arm" sensation during sport or overhead activity
- Pain, weakness, and reduced confidence in the shoulder during daily activity
Symptoms can vary depending on the severity and direction of instability. Any patient who has experienced a shoulder dislocation, or whose shoulder feels chronically unstable, should be evaluated by an experienced shoulder specialist as soon as possible.
Will my shoulder dislocate again after a first-time dislocation?
The risk of recurrence after a first-time shoulder dislocation depends significantly on age and activity level. In young athletes, the recurrence rate without surgical stabilization can be as high as 80 to 90 percent. In older, less active patients, recurrence is less common and conservative management is often sufficient. Dr. Duany will assess the structural damage from your dislocation, review your imaging, and have an honest conversation with you about your personal risk of recurrence and whether surgical stabilization is in your best interest.
What does shoulder instability surgery involve?
The most common surgical procedure for shoulder instability is an arthroscopic Bankart repair, in which the torn labrum is reattached to the front of the glenoid socket using small anchors. Dr. Duany performs this procedure arthroscopically, allowing for a minimally invasive approach. Key points about surgery and recovery include:
- Performed as an outpatient procedure in most cases
- A period of immobilization in a sling following surgery to protect the repair
- Progressive physical therapy beginning within a few weeks to restore strength and range of motion
- Return to sport or high-demand activity typically at four to six months post-surgery
- High success rates for restoring shoulder stability in appropriately selected patients
How do I find a shoulder dislocation doctor near me in Louisville, KY?
If you are searching for a shoulder specialist near you or a shoulder surgeon near you in the Louisville area, Dr. Duany makes it easy to get started. Simply fill out our online appointment request form or call us at (502) 629-5633, and our team will follow up to confirm your visit. Dr. Duany sees patients at two convenient Louisville locations and is dedicated to providing expert, personalized shoulder care to patients throughout the metro area and surrounding communities. We look forward to helping you recover and return to the activities you love.