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Shoulder Instability

Have you got Shoulder Instability?

If you have shoulder instability, you probably know it.  It is a feeling of not trusting the shoulder to 'stay in place'.  It can sometimes be confusing trying to figure out why you have it, and if you DO have it, what needs to be done to help? We can help!

There's some important things to get your head around first!

The Shoulder AKA The Gleno Humeral Joint

Your shoulder is an amazing joint with enormous mobility.  However it relies heavily on the surrounding ligaments (bone to bone) and tendons (muscle to bone) to hold the ball on the socket.  If there is a problem with either then your shoulder can feel unstable and painful.

Your shoulder or glenohumeral jont (GHJ), is made up of a few different structures.  All of which are important for a healthy pain free shoulder.

Let's start with the bones. You have a 'socket' (glenoid) which is made by part of your shoulder blade (scapula) and a 'ball' which is the top end of your upper arm (humerus).

The easiest way to think of it, is like a golf ball on a big golf tee. So the ball rests on it rather than inside it. There is also a soft tissue cup that helps the fit and stability of the ball on socket called the labrum.

There are bone to bone structures called ligaments which help to limit movement between the bones and of course you have muscles.

4 muscles called the rotator cuff help keep the ball on the socket. They are called the supraspinatus, infraspinatus, subscapularis and teres minor. They are thin and flattish but should be strong.

Another muscle called your biceps also runs over the ball and attaches near to the socket so also plays an important role in stabilising your shoulder.

Without boring you senseless they are the main things to think about.  If ALL these things are working normally and NOT injured then you should have a pain free shoulder.

Shoulder Instability & Proprioception

All of the structures above have sensory nerve endings in.  The nerve endings constantly give information back to your brain so it can react. Your brain turns muscles on and off to make sure the ball remains on the socket.

The information from these structures (ligaments & tendons) is referred to as proprioception.  Your shoulder requires all the structures to NOT be injured to be stable. 

Shoulder laxity means the movement of the ball on the socket is maybe more than the average person but DOES NOT give you any symptoms. For example a bendy gymnast. 

Shoulder instability is where you have symptoms from an abnormal movement of your shoulder which results in pain, subluxation (ball a bit off socket) or dislocation (ball totally off socket).

Shoulder Instability Types

There are 3 main types of problem

Type 1

The first group is anyone who has dislocated their shoulder through a traumatic injury. This injury will mean that a ligament (bone to bone tissue) has been stretched or torn.  It can also mean damage to the labrum.  This labral damage is referred to as a Bankart lesion.  This type of problem normally requires surgery to repair the damaged structures. Unfortunately they do not heal by themselves.  

Type 2

The second group are people who are HYPERMOBILE. This means that your soft tissues are more flexible than the average person.  This is not a problem in itself, but if your shoulder muscles don't work well it can lead to instability and dislocation.  If you were born bendy and HAVE NOT disclocated or injured your shoulder this is you.   Rehabilitation is the BEST treatment for you.

Type 3

This group have something called 'muscle patterning'.  It refers to your muscles doing weird things that you DO NOT want them to be doing! Mismatched, abnormal pushing and pulling forces by the muscles around your shoulder can result in subluxation and dislocation.  It most commonly appears in your latissimus dorsi, pectoralis major and deltoid muscles.   

It is VERY important to assess which group you are in to identify whether you are most suitable for rehabilitation or if you actually require surgery.  

For example if you have dislocated your shoulder but have developed muscle patterning issues, you NEED rehab before any possible surgery.  If you had surgery but still had muscle patterning issues, your surgery would likely fail and you will continue in pain and with instability.  

Why does muscle patterning happen?

No one really knows.  It is thought that it's a combination of factors such as some structural change in the joint which in turn lead to altered rotator cuff AND surrounding muscle activity.  The good news is, it can be changed!

If you are reading this and the information sounds familiar, get in touch.

The longer you wait the harder the problem is to resolve! Take action now.

Rehab is the number one way to reduce pain.  Sometimes if you have completely torn some ligaments you may require surgery, but then guess what you need? Rehab!

People in pain often leave it a long time before asking for help,

they don't know what is wrong, and worry about the future.

We specialise in modern physio to help people

live the life they want and keep doing the things they love.

Tell us how your shoulder pain affects you:


    5 Top Shoulder Pain FACTS


      Shoulder pain making your life miserable?

      End your shoulder pain and stiffness with our expert help


      We'll help you find out what's wrong

      We'll give you peace of mind so that you are confident and know you are safe to keep moving

      We'll help you to keep active

      Stay healthy and do what you love whether its walking, running, playing sports or chasing after your kids all day!


      We'll help you to stay free from painkillers

      No more reaching for the medicine cabinet. PLUS - they're no good for your long term health anyway, they don't actually do anything to fix the problem, they just mask it

      We'll help you to avoid unnecessary surgery

      We’ll quickly help you understand the root-cause of what’s going on so you can learn most things get better without surgery instead of it being the first and only option


      We'll help you to get more enjoyment out of life!

      Relax and enjoy the quality time with your family and friends that aches and
      pains can steal from you, and finally get a good night sleep without tossing and turning

      We have helped thousands of people get better from shoulder pain.

      From a 1 week episode to 10 years worth of pain. It’s the third most common problem that we see in our physio clinic in Macclesfield Cheshire.

      When it comes to shoulder pain, it feels like everyone has an opinion on what’s best for you. It can be confusing to know who to listen to and who to trust. Most of the advice is often out of date.

      One thing that is certain about shoulder pain is that YOUR shoulder pain and the contributing factors to it are individual to you. So what might have worked for a friend will not work for you.

      If one treatment worked for everyone then shoulder pain would not be the problem it is!

      Frequently heard problems

      Here are some things that our clients have said to us about their
      shoulder pain before they came to us.

      “I have tried other treatment in the past but nothing they said or did seemed to help”

      Mark - 52

      'I thought it would just go away, but it didn't'

      Suzanne - 43

      “Pain killers have not got rid of my pain”

      Margie - 72

      “Someone told me shoulder pain is a sign of aging and I just accepted it!”

      Kenny - 68

      “I have tried exercise videos for shoulder pain but they don’t help and sometimes make it worse”

      Alex - 23

      We have helped over
      satisfied customers!

      I recently saw Hogan & Mitchell over a long term shoulder issue I've been experiencing. A a detailed assessment was carried out and the issue was patiently explained, how it was caused and the treatment needed to address it. Within a month I've seen a massive improvement; in fact I'm no longer having any restriction or pain. Highly recommended.

      Kevin I.

      I have suffered from neck and shoulder pain for many years and always found even simple gardening jobs almost impossible due to the resulting pain, stiffness and discomfort. However, since seeing Hogan & Mitchell I am virtually pain free. This was highlighted to me recently when I dug out heavy clay soil and laid patio bricks without any repercussions, something which would not have happened a year ago. I can now carry on doing jobs which had become impossible.

      Liz E.

      The "Get Rid of Your Shoulder Pain Plan"

      1. Book an appointment
      2. Get a diagnosis
      3. Get a bespoke treatment & rehab plan
      4. Carry out the plan (important!)
      5. Get better!

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      The Hogan & Mitchell Guarantee

      1. We promise to listen to you and explain your problem in a way that makes sense to you, and tell you how long it will take to get better

      2. We promise to be honest about what will & won’t help you

      3. We promise you a positive experience of what real modern physio is and what we can help you achieve, WITHOUT machines or acupuncture!

      4. We promise that if we cannot solve your problem, we will put you in touch with the right person who can.



      Pain problem? Talk to us

      01625 422 855