Capsule Tear

Shoulder Dislocation & Chronic Shoulder Instability
The shoulder is the most mobile joint of the body. The shoulder joint has functions such as lifting the arm up, turning it around and reaching the hand above the head.
A shoulder dislocation is when the upper part of the arm is forced out of the shoulder joint in the form of a socket. This can also occur as a result of overuse of the shoulder or a fall.

Once the shoulder is dislocated, it is often at high risk of recurrent dislocations of the shoulder joint. Chronic shoulder instability is a recurrent dislocation of the shoulder joint that becomes loose and creates insecurity and instability. Continuous Shoulder Dislocation (Chronic Shoulder Instability)

The knob of the arm can sometimes protrude out of this socket and become half dislocated, which is called a subluxation, and the complete dislocation of the knob from the socket is called a full dislocation.
Once the shoulder is dislocated, it can tear or overstretch the surrounding soft tissues (ligaments, capsule, tendons or muscles) that hold the socket and knob together. This can lead to recurrence of dislocations. This is called chronic shoulder instability or laxity. There is a permanent failure of the soft tissues that hold the shoulder joint together.

Shoulder Dislocation:

It is usually caused by a fall or traffic accident. The knob tears the connective tissues in front of the socket as it exits. This is called a bankart lesion. A severe initial dislocation can cause permanent dislocations. There may be a feeling of dislocation or a feeling of insecurity in the shoulder as if it will dislocate.

Recurrent Shoulder Strains:

In sports such as swimming, tennis or volleyball, the shoulder is constantly forced above head level, which can lead to laxity, stretching and instability of the shoulder ligaments. Repetitive and stressful activities such as these create a slow-developing connective tissue damage in the shoulder. These damaged or loose ligaments can cause pain and instability in demanding shoulder movements.

Multidirectional Instability: In this very rare condition, the shoulder is loose in all directions, such as backwards, forwards and downwards. Such patients may have a flexible connective tissue disease at the root.

Clinical Findings in Shoulder Dislocation

The most common manifestations of chronic shoulder instabilities;

Shoulder pain with injury
Recurrent shoulder dislocations
Constant feeling of looseness, jumping or dislocation of the shoulder.

Imaging Methods in Shoulder Dislocation
A shoulder X-ray and MRI are ordered for differential diagnosis.
The X-ray will show damage and injury to the shoulder bones. MRI is used to evaluate the structure and injury of the connective tissues around the shoulder.

Treatment of Shoulder Dislocation

Chronic shoulder instability is first treated with non-surgical methods. If pain and shoulder instability persist as a result of this treatment, surgery is planned, which is usually required for most patients.

Non-surgical Treatment

The planning of this treatment includes life modification, avoiding movements that cause shoulder dislocation. This treatment lasts for several months.
Non-steroidal medications and ice therapy are used to reduce pain and swelling.
Physical Therapy: It strengthens your muscles around the shoulder.

PRP, Prolotherapy can be applied for capsule problems.

Surgical Treatment of Shoulder Dislocation

The main goal of the surgery is to repair torn and loosened ligaments around the shoulder.
Repairing these ligaments is done with open and closed surgeries;

Closed; It is performed with arthroscopic methods. It is a current treatment method performed with small instruments and camera system without opening the shoulder joint. Patient comfort is high and hospital stay is short.

Open surgery; Here, the shoulder joint is opened with a large incision and soft tissue repair is performed under direct vision.

Rehabilitation; After the shoulder is temporarily rested in special slings after surgery, it is taken into a special physical therapy program. The range of motion of the shoulder joint is increased by strengthening the shoulder muscles, stretching and strengthening the connective tissues. Return to normal life and rehabilitation is shorter in arthroscopic surgeries.

By adapting to the treatment plan together with your doctor, you can regain your old shoulder activities.