Shoulder Instability Info

Q: Will my shoulder dislocate again after stabilisation?

Recurrence after stabilisation depends mostly on the same factors that cause instability in the first place: age (younger patients have higher rates), bone loss on the glenoid or humeral head, the demands of the patient's sport or work, and whether the surgical construct addressed all the contributing factors. Published recurrence rates after arthroscopic Bankart repair vary widely — rates are higher in young contact-sport athletes than in older patients with first-time dislocations. The Latarjet bone-block alternative offers lower recurrence rates in high-demand patients with bone loss, at the cost of a more invasive operation.

Q: What's the difference between an arthroscopic stabilisation and a Latarjet?

Arthroscopic stabilisation is a soft-tissue operation: the torn labrum is reattached and the anterior capsule is tightened. It works well when the labrum is repairable and bone loss is minimal. A Latarjet is a bone-block operation: a piece of the coracoid process is transferred to the front of the glenoid to compensate for bone loss and to add soft-tissue restraint via the conjoint tendon. Latarjet is more invasive but offers lower recurrence rates in high-risk patients. The choice is made from imaging and the patient's demands; Dr Hirpara has published on the arthroscopic Latarjet technique.

Q: When can I return to contact sport?

Six to nine months is typical, depending on the construct, the sport's demands, and the post-operative response. Non-contact sport (running, swimming, cycling) is usually possible by four to six months. Contact and overhead-throwing sports — rugby, AFL, water polo, throwing events — require the longest rehabilitation because they impose the most stress on the repair. The post-operative review schedule includes a sport-specific clearance discussion at three and six months.

Q: What's the success rate of shoulder stabilisation?

Published outcomes for arthroscopic Bankart repair report shoulder stability in roughly 80–90% of properly selected patients at medium-term follow-up, with high rates of return to pre-injury function. Outcomes are best in patients with classic anterior labral tears, minimal bone loss, careful adherence to post-operative protocol, and a thorough rehabilitation programme. Outcomes are poorer where bone loss has been under-recognised or where the patient returns to high-demand contact sport before the construct is mature; the consult discusses individual risk factors.

Q: How much does shoulder stabilisation cost? What does Medicare cover?

Shoulder stabilisation is performed under regional and general anaesthesia, so a separate anaesthetist gap applies on top of the surgeon and hospital fees. The practice quotes the surgical fee in writing before booking — the Medicare item, the rebate and the out-of-pocket gap each shown separately. Dr Hirpara's surgical fees follow the Australian Medical Association schedule, which is higher than the Medicare scheduled fee; the fees page explains why. Surgery does not proceed without itemised written informed financial consent.

Q: What if my shoulder keeps dislocating after the surgery?

Recurrent instability after a stabilisation operation is investigated carefully. The MRI is usually repeated to assess the labral repair and to look for bone loss that may have progressed since the original surgery. Where the failure is from progressive bone loss or a failed soft-tissue construct, a revision procedure — most commonly a Latarjet — is considered. The decision is individualised; revision instability surgery is more demanding than primary surgery and is best managed by a surgeon who handles the full instability spectrum.

Q: Do I need physiotherapy after shoulder stabilisation?

Yes — shoulder physiotherapy is integrated into the post-operative pathway and is the most important factor in the long-term result. The schedule runs gentle range of motion in the first six weeks (under sling protection), active motion from six weeks, scapular and rotator cuff strengthening from twelve weeks, and sport-specific rehabilitation from four to six months. Shoulder physiotherapy is provided by George Labor in the same suite as Dr Hirpara's rooms. Patients from outside Rockhampton can usually arrange ongoing therapy closer to home after the early intensive sessions.

Glenoid labral tear shown around the rim of the shoulder socket. — The labrum is a soft cartilage rim that deepens the shallow shoulder socket. When it tears — often during a dislocation — the joint loses its key restraint and starts to feel unstable. InjuryMap 4.0

Shoulder instability — understanding the feeling of looseness, causes, and treatment options.

What you're feeling

You may feel pain in your shoulder that signals larger tissue damage. This pain often acts as a warning sign when you have shoulder instability. You might notice discomfort when reaching behind your back to fasten a bra or tucking in a shirt. Simple daily tasks can become difficult if your shoulder feels loose or painful.

Your symptoms can vary depending on the type of instability you have. If you have posterior instability, the condition is often hard to diagnose and can be technically challenging to treat. You might experience pain during motion without a clear feeling of the joint slipping out. Some patients feel minor instability that presents as extra-joint impingement symptoms. Pain can also flare up at night or after activity, making it hard to sleep on that side.

In some cases, you may have microinstability, which is difficult to diagnose. Young patients often report ambiguous shoulder pain during movement without a full dislocation. If you have recurrent posterior instability, the condition can be difficult to treat but reliable recovery is possible with modern arthroscopic management. Your surgeon will look closely at your bone loss and specific pathology to determine the best path forward for your recovery.

What's actually happening

Your shoulder is a ball-and-socket joint that relies on a tight sleeve of tissue called the joint capsule to stay in place. When you have instability, this sleeve stretches or tears, allowing the ball to slip out of its socket. This movement is not normal. Even a small change in how your shoulder moves, known as a 5% shift in motion, can alter how the joint works and cause pain.

The problem often involves the soft tissues that act like ropes and gaskets around the joint. Tears in these tissues, especially the subscapularis tendon, change how your shoulder handles weight and movement. This can cause the ball to slide forward or upward more than it should. While surgery aims to tighten these tissues, no current method can fully restore your shoulder to its exact pre-injury state.

Your surgeon looks at your specific bone loss and tissue damage to decide the best path. For some, the Latarjet procedure offers a durable solution for long-term stability. However, surgery is not done just to prevent future games or boost performance. The goal is to fix the mechanical failure so you can move without fear of the joint slipping again.

What we can do about it

Your journey often begins with self-management and physiotherapy. You might try resting the shoulder and avoiding movements that cause it to slip out. Physical therapy aims to strengthen the muscles around your joint to keep it stable. This non-surgical approach is often the preferred strategy if your chance of the shoulder slipping again is low after this care. However, please know that nonoperative treatment can carry substantial societal costs for you and your community. While this path may help you return to play faster, it does not prevent future dislocations as well as surgery does.

If pain persists, your surgeon may discuss medical management options. These include pain medication and anti-inflammatories to help you feel better in the short term. In some cases, injections like cortisone or hyaluronic acid might be used to reduce swelling and pain. While these treatments can provide relief, the evidence does not specify exactly how long the effect lasts for every person. Your surgeon will decide if these are right for you based on your specific symptoms and exam.

Surgery is considered when conservative care has reached its limit or if you are young and at high risk for recurrence. Your surgeon may recommend stabilization to restore joint stability while minimizing loss of motion. This is especially true for adolescents and young adults under 40 years of age with a first-time dislocation, where surgery is more effective than non-surgical options. The goal is to stop the shoulder from slipping out again so you can enjoy a longer, more active career.

When to see someone

See your GP if you have persistent shoulder pain that does not improve with rest. Ask for a specialist review if your shoulder feels weak, unstable, or gives way. You should also seek help if the joint locks or symptoms interfere with your sleep or work. Sudden worsening of symptoms is another reason to consult. Recurrent instability occurs in roughly one-third of patients under 40 after an initial dislocation. If you have a history of dislocation, long-term follow-up is important as outcomes can change over time.