Your shoulder joint needs to be flexible to allow you to reach and move your hands for all the activities you undertake during the day but the feeling that your shoulder joint is lax or sliding slightly out of place can be very disconcerting.

As physios we call this ‘shoulder instability’ and this condition ranges from more mild symptoms (subluxation) to complete dislocation of the joint.

What causes instability of the shoulder?

There are three main causes of shoulder instability:

  1. Direct injury of your shoulder joint causing a complete or partial dislocation
  2. Repetitive over-head movements
  3. Poor muscular support around the shoulder joint (generalised laxity or hypermobility)

Whether you’ve had a dislocation or have generalised laxity, the initial advice is the same. Start to gently move and use your shoulder as soon as possible. Early movement will help restore both strength and coordination in the support muscles around your shoulder (rotator cuff) and shoulder blades which are responsible for lining the joint up properly and keeping it in place while your arm is moving.

If you have completely dislocated your shoulder, you may be given a sling to wear initially. This should not be worn for more than a week unless specified by a consultant. Beyond this period the sling should only be used for short periods to rest and relieve pain.

What exercises are recommended for shoulder instability?

In the first 3-weeks all movements should be carried out in a ‘safe zone’. This means moving your arm within your field of vision (you should always be able to see your hand or arm when looking straight ahead). You should feel comfortable and confident with each exercise.

Avoid stretches within these first few weeks and focus on exercises which involve leaning a bit on your arm as this fires up the support muscles around your shoulder and shoulder blade.

Place your hand on a table in front of you and lean gently through your arm. Hold for up to 10 seconds. You can gradually increase the amount of weight you put through it but stay below pain levels.

Early strengthening exercises for the rotator cuff muscles

‘Press and hold’ exercises are ideal for the early stages to strengthen the rotator cuff muscles around your shoulder. Hold each position for 10 seconds, relax and repeat 5 times.

  1. Face the wall, make a fist and gently push your fist into the wall. The movement wants to come from your shoulder, do not lean into the wall using your body-weight.
  2. Standing with arm in same position but with your back to the wall. Gently push your elbow backwards into the wall.
  3. Standing with arm in same position side-on to the wall (affected arm closest to the wall). Gently push the outside of your forearm into the wall.
  4. Standing with your arm in the same position, place your opposite hand on the inside of your forearm and use it to resist moving your arm inwards across your body.

A physiotherapist will be able to help you progress your exercises at the right stage to build strength, coordination and restore pain free movement again.

Please don’t hesitate to get in touch if you have any questions.

The Physiofit Team!