A shoulder that feels loose, keeps slipping, or has already dislocated typically does not improve without treatment. Without proper shoulder instability treatment, repeated episodes cause additional damage to the labrum, ligaments, and bone, and each one makes the next more likely.
Dr. Michael Bercik is a board-certified orthopedic surgeon in Lancaster, PA who provides shoulder instability treatment for patients across Lancaster County. With sub-specialty training in shoulder surgery, two international shoulder fellowships, and residency at the Rothman Institute in Philadelphia, he has the focused experience to accurately diagnose the type and cause of instability and recommend treatment that fits the specific situation. His offices are located in Lancaster, Ephrata, and Mount Joy.
What Is Shoulder Instability?
The shoulder is the most mobile joint in the body, which also makes it the most vulnerable to instability. Shoulder instability occurs when the ball of the upper arm bone slips partially or completely out of the shoulder socket. When the ball comes fully out, it is called a dislocation. When it slips partially and returns on its own, it is called a subluxation.
Some patients experience a single traumatic dislocation and recover without further episodes. Others deal with recurrent instability that happens with less and less force over time, or a persistent sense of looseness that limits activity and erodes confidence in the shoulder.
The underlying cause of instability matters because it shapes what shoulder instability treatment is needed. Structural damage to the labrum or ligaments calls for a different approach than generalized joint laxity, and treatment is tailored accordingly.
Types of Shoulder Instability
Traumatic instability results from a specific injury, typically a fall, collision, or forced overhead motion. The labrum, the ring of cartilage that deepens the shoulder socket, is often torn in these cases. A Bankart lesion, which is a tear of the labrum at the front of the socket, is the most common structural injury associated with traumatic dislocation.
Atraumatic instability develops without a specific injury, often in patients whose joints are naturally more flexible. These patients may notice the shoulder slipping in multiple directions without a clear mechanism of injury.
Recurrent instability describes the pattern that develops after an initial dislocation when the shoulder continues to give way. This is especially common in younger patients and athletes. The risk of recurrence after a first dislocation is high in this group, and repeated episodes increase the likelihood of additional structural damage.
Multidirectional instability involves looseness in more than one direction and is more common in patients with generalized ligamentous laxity. Shoulder instability treatment for this type often requires a very different treatment approach than traumatic instability.
Symptoms of Shoulder Instability
Instability does not always feel dramatic. Many patients describe a range of sensations that vary from person to person.
A feeling that the shoulder might give out. Some patients describe a sense of apprehension during certain movements, particularly reaching overhead or throwing.
Repeated dislocations or subluxations. The shoulder coming fully or partially out of the socket, either during activity or with everyday movement.
Pain during overhead or rotational movements. Certain positions that load the front of the shoulder trigger significant discomfort.
Weakness or dead arm sensation. Some patients notice a brief episode of arm weakness or numbness during certain movements, particularly in overhead athletes.
Clicking, popping, or catching. Structural damage from prior dislocations can cause mechanical sensations inside the joint.
Decreased confidence in the shoulder. Many patients begin to unconsciously limit activity or avoid certain movements out of fear of another episode.
How Shoulder Instability Is Diagnosed
Accurate diagnosis is essential because shoulder instability treatment depends on understanding the type, direction, and cause of the problem, as well as the extent of any structural damage.
Dr. Bercik conducts a detailed physical examination using specific tests to assess the direction and degree of instability, labral integrity, and the condition of the surrounding musculature and ligaments. A thorough history of how the instability started and how it has progressed helps establish the diagnosis.
Imaging is typically part of the evaluation. X-rays can identify bony injuries such as a Hill-Sachs lesion on the humeral head or a bony Bankart lesion on the socket rim. MRI, often with contrast, provides detail on labral tears, ligament damage, and soft tissue involvement. CT scans may be used to measure bone loss at the socket, which is an important factor in choosing between treatment options.
Non-Surgical Shoulder Instability Treatment
Not every patient with shoulder instability requires surgery. Conservative shoulder instability treatment is often the appropriate starting point, particularly for patients with atraumatic or multidirectional instability, first-time dislocators who are not young athletes, or patients with mild symptoms and no significant structural damage.
Physical therapy is the foundation of non-surgical treatment. A structured program focuses on strengthening the rotator cuff and the muscles around the shoulder blade, improving neuromuscular control, and retraining movement patterns that reduce the risk of the joint slipping. Many patients with atraumatic instability respond well to a dedicated, extended therapy program.
Activity modification helps reduce provocative positions while the shoulder is being strengthened through therapy.
Bracing may be used in some cases to provide external support during return to activity, particularly in contact sports.
Surgical Shoulder Instability Treatment
Surgery is typically recommended for patients with traumatic instability and structural damage, athletes with a high-risk of recurrence who need to return to demanding activity, patients who have not improved with conservative treatment, or anyone with significant bone loss at the socket that increases the risk of further episodes.
Arthroscopic Bankart Repair
For most patients with traumatic instability and labral damage, arthroscopic Bankart repair is the primary surgical option. Small incisions allow a camera and instruments to be guided into the joint. The torn labrum is reattached to the socket rim using suture anchors, restoring the structural bumper that normally keeps the ball in place. This minimally invasive procedure has well-established outcomes for appropriate candidates.
Arthroscopic Latarjet Procedure
For patients with significant bone loss on the socket side or a high risk of recurrence, the Latarjet procedure provides more robust stabilization. A small piece of bone from the shoulder blade is transferred to the front of the socket, effectively deepening it and creating both a bony block and a sling effect to prevent the joint from slipping forward.
Dr. Bercik performs the arthroscopic version of the Latarjet procedure, achieving the same structural goals through smaller incisions than the traditional open approach. This is a technically demanding procedure, and the arthroscopic version in particular requires a high level of shoulder-specific surgical experience.
Capsular Shift and Ligament Tightening
For patients with multidirectional instability where the joint capsule is too loose, a capsular shift procedure tightens the surrounding tissue to reduce excessive play in the joint. This may be performed arthroscopically or through a small open incision depending on the extent of the repair needed.
Recovery After Shoulder Instability Surgery
Recovery depends on the procedure performed, but most patients follow a progression through several distinct phases.
The shoulder is typically protected in a sling for the first several weeks to allow repaired tissue to heal. Physical therapy begins early with gentle range of motion work before advancing to strengthening and eventually sport-specific or activity-specific training.
Most patients return to light daily activity within a few weeks. Return to contact sports or heavy overhead activity typically takes four to six months for Bankart repair and somewhat longer for Latarjet. Following the rehabilitation program consistently and not returning to demanding activity before the shoulder is ready significantly reduces the risk of recurrence.
Why Patients Choose Dr. Bercik for Shoulder Instability Treatment
Effective shoulder instability treatment starts with accurate diagnosis of both the type and the structural cause of the problem. The difference between a patient who needs physical therapy and one who needs a Latarjet procedure is not always obvious, and getting that distinction wrong leads to failed treatment and continued instability.
Dr. Bercik’s fellowship training, Rothman Institute residency, and exclusive focus on shoulder conditions give him the clinical depth that matters in exactly these cases. He performs both arthroscopic Bankart repair and arthroscopic Latarjet, which means patients are not being steered toward a procedure based on what a surgeon is or is not trained to offer.
His practice sees a significant volume of instability cases, particularly in athletes and younger patients, giving him the pattern recognition and technical experience that complex instability cases require.
Shoulder Instability Treatment FAQs
Who provides shoulder instability treatment in Lancaster, PA? Dr. Michael Bercik is a board-certified orthopedic surgeon with sub-specialty training in shoulder surgery who provides shoulder instability treatment at offices in Lancaster, Ephrata, and Mount Joy, PA.
Will my shoulder improve without surgery? Some patients, particularly those with atraumatic or multidirectional instability and no major structural damage, improve significantly with physical therapy. Patients with traumatic instability, labral tears, or bone loss are less likely to achieve lasting stability without surgery.
What is a Bankart lesion? A Bankart lesion is a tear of the labrum at the front of the shoulder socket. It is the most common structural injury associated with a traumatic shoulder dislocation and is the target of arthroscopic Bankart repair.
What is the Latarjet procedure? The Latarjet procedure transfers a small piece of bone to the front of the shoulder socket to deepen it and prevent the joint from dislocating. It is used when there is significant bone loss or a high risk of recurrence that a soft tissue repair alone cannot adequately address.
How likely is my shoulder to dislocate again after surgery? Recurrence rates after arthroscopic Bankart repair in appropriate candidates are low. The Latarjet procedure has similarly strong outcomes and is typically chosen when recurrence risk is elevated due to bone loss or activity demands.
Can I return to contact sports after shoulder instability surgery? Many athletes return to contact sports after shoulder stabilization surgery. The timeline and recommended procedure depend on the degree of instability, the presence of bone loss, and the demands of the sport.
Is shoulder instability surgery performed arthroscopically? Both Bankart repair and the Latarjet procedure can be performed arthroscopically. Dr. Bercik performs the arthroscopic version of both, which typically means smaller incisions and less disruption to surrounding tissue.When should I see a doctor about shoulder instability? After a first dislocation, prompt evaluation is worthwhile to assess for structural damage and understand the risk of recurrence. Ongoing symptoms of looseness, repeated subluxations, or a shoulder that has dislocated more than once should be evaluated without significant delay.
