In short
The shoulder trades stability for mobility. That trade-off is why it dislocates more easily than any other joint, and why recurrence is so common in young athletes.
The shoulder is the most mobile joint in the body, and it achieves that range by sacrificing bony stability. The ball sits against a shallow socket, held largely by soft tissue. That design is why it dislocates more readily than any other joint.
Dislocation
In the great majority of cases the shoulder comes out forwards, typically when the arm is forced into an outstretched, rotated position — a fall onto an outstretched hand, a tackle, or a badminton smash gone wrong.
When it dislocates, the labrum — a rim of cartilage deepening the socket — is often torn. Once that rim is damaged, the socket is effectively shallower, which is why the shoulder becomes prone to dislocating again.
When surgery is discussed
- Young athletes after a first dislocation, where recurrence risk is high
- Repeated dislocations, or a shoulder that subluxes during normal activity
- Significant bone loss from the socket or the humeral head
- Contact and overhead sports where the arm is repeatedly at risk
Stabilisation is usually arthroscopic, reattaching the torn labrum with anchors. Where there is significant bone loss, a bone-block procedure may be needed instead.
Rotator cuff injuries
The rotator cuff is a group of four tendons that hold the ball centred in the socket and power rotation. Tears fall into two broad groups.
Traumatic tears occur suddenly, often in a fall, and typically produce immediate weakness — difficulty lifting the arm to the side, for instance. Degenerative tears develop gradually with age and overuse, and often cause more pain than weakness, particularly at night when lying on the shoulder.
Treatment
Many cuff problems respond to physiotherapy focused on the scapular stabilisers and remaining cuff muscles, sometimes assisted by a corticosteroid injection to break the pain cycle enough for rehabilitation to progress.
Repair is more likely to be recommended for acute traumatic tears, for significant weakness, and in younger patients where an untreated tear is likely to enlarge over time. Repair is usually arthroscopic, and the rehabilitation is long — the tendon must heal back to bone before it can be loaded.
If you have dislocated a shoulder or have shoulder pain that disturbs your sleep, our sports medicine team can assess whether rehabilitation or surgery is the right path.
Frequently asked questions
Will my shoulder dislocate again?+
In athletes under twenty-five, recurrence after a first dislocation is common — reported in a substantial proportion of cases. Risk falls considerably with age. This is the main reason stabilisation surgery is discussed early in young athletes.
Do all rotator cuff tears need surgery?+
No. Many partial and degenerative tears respond well to physiotherapy. Acute traumatic tears in younger patients, and tears causing significant weakness, are more likely to be repaired.
How long does rotator cuff repair take to heal?+
The tendon takes months to heal to bone. Sling protection for around four to six weeks is typical, with a graded programme over three to six months and full strength often taking closer to a year.
This article is general health information, not medical advice, and it cannot account for your individual circumstances. Please consult a qualified orthopaedic specialist about your own symptoms before making treatment decisions.
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