First dislocation · Recurrent instability · Five Dock

Shoulder instability and dislocation

A shoulder that has come out once is more likely to come out again. What happens in the months afterwards changes that number.

A dislocation stretches or tears the structures that hold the joint together, and the shoulder afterwards is often not just weaker but harder to control in the positions where it feels least secure. Recurrent instability is when that keeps happening, sometimes with less and less force each time.

Rehab for instability is not the same as rehab for a painful shoulder. The work is about control in the vulnerable positions, strength through range, and eventually re-exposing the shoulder to the things that put it at risk in the first place, which for most people means overhead positions and contact.

Bent-over band row for the shoulder blade muscles, SportsFit logo on the wall behind
The programme

What instability rehab covers

Roughly in order, though the stages overlap and the timeline depends on what was injured.

Settling and protected range

Early on the shoulder is sore and the priority is regaining range in the directions that are comfortable while keeping the joint out of the positions that threaten it.

Strength through range

Rotator cuff and shoulder blade strength, built in positions that are tolerated and then progressively closer to the ones that are not. Measured on both sides so progress is visible.

Overhead control

The position most shoulders feel least secure in, and the one most often skipped. Loading overhead is a stage in its own right rather than something that happens by accident at the end.

Contact preparation

For anyone going back to a contact sport, the shoulder needs exposure to force it did not choose. Skipping this is the most common reason a shoulder feels ready in the gym and does not hold up on the field.

Detail

Surgery, and when it comes up

Not every unstable shoulder needs an operation, and not every one avoids it. The things that tend to push the conversation toward surgery are how many times it has come out, how little force it takes, how old you were at the first dislocation, what the imaging shows about the bone and the labrum, and what you want to go back to.

The two operations we see most

  • Arthroscopic stabilisation, where the labrum and capsule are repaired through keyhole surgery
  • Latarjet, where a piece of bone is transferred to the front of the socket, usually where there is bone loss or where a previous repair has not held

Both have staged rehab afterwards and both are protocol-driven, which means your surgeon sets the range and loading limits and we work inside them. There is a page on this site for Latarjet rehab specifically.

Taping

Taping does not hold a shoulder in place, and anybody who tells you it does is overselling it. What it can do is give you feedback about where the arm is, which some people find useful while the shoulder is still settling or during a return to sport. We will show you how to do it yourself.

Instability

What the rehab actually looks like

Strength work in overhead positions, preparation for contact, and the taping we use while a shoulder is still settling.

End stage shoulder stability: overhead and contact preparation
End stage shoulder stability: overhead and contact preparation
Anterior shoulder stability taping
Anterior shoulder stability taping
Common questions

Questions we get asked

How long before I can play again?
It depends on the sport, whether you had surgery, and how the strength testing looks. We will give you a range early and update it as the numbers come in rather than picking a date at the start.
My shoulder went back in by itself. Does that still count?
Yes. A shoulder that comes out and relocates on its own has still been through the same event and is worth assessing.
Will I definitely need surgery?
No. Plenty of unstable shoulders are managed without it. Whether yours is one of them is something to work out with a surgeon, and the rehab is worth starting either way.
Do you work with shoulder surgeons?
Yes. We correspond with the surgeon looking after you and work to their protocol. We also host teaching sessions in the clinic, including one run by an orthopaedic shoulder surgeon for our physiotherapists.

Shoulder come out, or feel like it might?

Book a free 30 minute call and tell us what happened. We will tell you what an assessment would look at and whether a surgical opinion is worth getting.

No gap on an accepted claim · You choose your own physio · Five Dock