Shoulder instability
Shoulder instability occurs when the structures surrounding the shoulder joint fail to keep the upper arm bone securely centered in its socket, causing the joint to feel loose, slip, or repeatedly dislocate.
What causes shoulder instability?
Shoulder instability typically develops through three primary mechanisms: Post-traumatic instability: The most common cause, following an acute injury or traumatic dislocation (e.g., from a collision in contact sports like rugby). The dislocation tears or stretches the anterior labrum and ligaments, leaving the joint permanently loose and prone to recurrent slipping. Repetitive strain and microtrauma: Common in athletes who engage in repetitive overhead movements (such as swimmers, tennis players, or throwers). Over time, repeated overhead stress stretches the stabilising ligaments, leading to gradual joint laxity and weakness. Multidirectional instability (MDI): Occurs in individuals who are naturally hypermobile or have generalized joint laxity. The shoulder joint can slip out of place in multiple directions (forward, backward, or downward) without a prior traumatic injury.
Primary symptoms
- Persistent feelings of shoulder looseness, slipping, or 'giving way' during daily tasks or sports
- Frequent episodes of partial dislocation (subluxation) or full dislocation
- Deep, aching shoulder pain, particularly during or after overhead activities
- Apprehension or anxiety when placing the arm in certain positions (e.g., raised and rotated backward)
- Sensations of clicking, catching, or weakness in the shoulder girdle
How is shoulder instability diagnosed?
Diagnosing shoulder instability involves a thorough evaluation by your consultant to assess joint laxity, directional instability, and muscle control, alongside ruling out nerve irritation or concurrent tendon injuries.
How is it treated?
Treatment depends on the underlying cause, the direction and frequency of instability, your age, and your physical demands.
Treatment routes for shoulder instability
Non-operative care is typically the first line of treatment, particularly for multidirectional instability or repetitive strain. This includes activity modification, avoiding positions that trigger slipping, taking anti-inflammatory medications (NSAIDs) for pain management, and using a supportive shoulder brace if recommended. A tailored physical therapy program focuses on strengthening the rotator cuff and scapular stabilizing muscles to dynamically hold the ball in the socket
Recovery from shoulder instability
Protection and immobilisation
Following surgery, your arm will be supported in a protective sling to safeguard the repaired ligaments and labrum. Focus on pain management, ice application, and gentle hand, wrist, and finger movements. Surgical dressings should be kept clean and dry, with stitches checked at 10 to 14 days.
Controlled weaning and passive mobility
You will gradually discontinue the sling under your physiotherapist’s guidance. Passive range-of-motion exercises begin, allowing movement without stressing the healing anterior ligaments or repaired tissue.
Active movement and progressive strengthening
Active arm movements are reintroduced. Physical therapy shifts toward strengthening the rotator cuff and shoulder blade stabilizers to rebuild dynamic joint support.
Sport-specific conditioning and full activity
Advanced strength conditioning and sport-specific drills are introduced. Return to non-contact sports typically occurs between 3 and 4 months, while full clearance for contact sports (such as rugby) or heavy overhead training usually takes 4 to 6 months post-surgery.
Working with professionals and teams
Our shoulder specialists support professional athletes, sports teams, active individuals and people whose work places high demands on their shoulders. Working closely with radiologists, physiotherapists and the wider multidisciplinary team, they provide coordinated care from diagnosis through to rehabilitation, helping each person return safely to sport, work or everyday activities.
The same specialist expertise and collaborative approach are available to every patient, whatever your activity level or recovery goals.
Our Experts - Leaders in Shoulder Treatment
How to pay
We offer flexible options depending on how you choose to access care at Fortius. Whichever option you choose, we’ll help make the process clear and straightforward from the start.
Private medical insurance
If your care is covered by private medical insurance, we’ll usually invoice your insurer directly. Please check your policy in advance and request an authorisation code if your insurer requires one. You’ll be responsible for paying any policy excess or costs that aren’t covered by your insurance.
Paying for yourself
You don’t need private medical insurance to access care at Fortius. If you’re paying for your own treatment, our team will explain the costs clearly and provide a personalised quote before you decide whether to go ahead.
Find a clinic near you
Fortius Clinic Marylebone Wing
Our 79,000 sq ft, seven-story, private hospital on Wigmore Street has 39 en-suite inpatient rooms, consultation and treatment rooms, and a physiotherapy suite.
The hospital has a high-spec imaging suite fully equipped with an MRI, CT scanner and X-ray machine. There are three state-of-the-art operating theatres, two anaesthetic rooms and a recovery bay.
Fortius Clinic London has two Mako robots for hip and knee joint replacements.
- 66 Wigmore StreetW1U 2SB
- +442031952442
- Open 24 hours
- Sports & Exercise Medicine
- Snow Injuries Clinic
- Tendon
- Ultrasound
- X-Ray
- Physician services
- Rheumatology
- CT guided injection
- MRI Scan
- CT Scan
Fortius Clinic Wimbledon
Our Wimbledon clinic houses a state-of-the-art imaging centre with a 3T MRI and X-ray scanners, Ultrasound, seven consulting rooms, two spacious waiting areas and well equipped treatment rooms all located on one level, ensuring easy accessibility for all patients.
Our partnership with Spire St Anthony’s Hospital allows us to provide orthopaedic surgery closer to our clinic. We treat a full range of conditions and perform joint replacement surgery using the latest Mako robotic assisted technology.
Take a tour of our clinic virtually through Google 360 views here.
We are open Monday to Friday from 8.00am to 8.00pm, and Saturday mornings from 8.30am to 12.30pm.
If you are travelling by Tube, our closest underground station is Wimbledon (District Line), which also has rail and tramlink services from central London and beyond.
There is no parking available at the clinic, but we have a number of parking facilities all within a 10-12 minute walk of the clinic: Centre Court Car Park, Broadway Car Park, and Hartfield Road Car Park. Please note that all of these facilities are paid car parks.
The building at 22 Worple Road has steps leading up to the front entrance. If you require assistance please inform us before your arrival by calling ahead on 020 3195 2442
- 22 Worple RoadSW19 4DD
- 0203 195 2442
- Snow Injuries Clinic
- Ultrasound
- X-Ray
- MRI Scan
Fortius Clinic Marylebone
Our Marylebone Clinic is conveniently located in the historic area between Baker Street and Marylebone High Street, just off Manchester Square, home to the iconic Wallace Collection. We have seven consulting rooms, private waiting areas on each floor, well equipped treatment rooms and diagnostic imaging.
- 17 Fitzhardinge StreetW1U 2EU
- 020 3195 2442
- MRI Scan
- Ultrasound
- X-Ray
- Physician services
- Rheumatology
Fortius Clinic City
Our City Clinic is conveniently located between Bank and Monument stations, within the historic and financial heart of London. At our modern, two-floor facility we have nine consulting rooms, spacious waiting areas, well equipped treatment rooms and an imaging centre.
Explore our City Clinic with our virtual tour.
If you are travelling by Tube, our closest underground stations are Bank and Monument, exit 6 for King William Street.
Should you be travelling by car, the closest parking is a three minute drive away at NCP Car Park London Vintry Thames Exchange. If you are attending clinic on a weekday, please be aware that we are based in the congestion charge zone.
- 75 King William StreetEC4N 7BE
- 0203 195 2442
- Monday to Friday from 8.00am to 8.00pm.
- Snow Injuries Clinic
- Tendon
- Sports & Exercise Medicine
- Ultrasound
- X-Ray
- Physician services
- Rheumatology
- MRI Scan
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