Neck & Shoulder

What It Is

Trauma to the shoulder is quite common. Injuries can range from a separated shoulder after falling onto it, to a high-speed car accident where the shoulder blade (scapula) or the collarbone (clavicle) is broken.

As a result of trauma, the shoulder joint can become loose or unstable. This typically happens after a ligament injury or a dislocation. Once a shoulder has dislocated, it is more likely to dislocate again (American Academy of Orthopaedic Surgeons, n.d.-b).

Instability can also happen without a dislocation. Some people naturally have looser ligaments (hyperlaxity, sometimes described as being "double-jointed"), so the shoulder is not held in the socket as tightly as it should be. Repeated overhead activities, such as swimming, tennis and volleyball, can also stretch the shoulder ligaments over time (American Academy of Orthopaedic Surgeons, n.d.-b).

Glenohumeral Joint Instability Anatomy

Three bones make up the shoulder: the collarbone (clavicle), the upper arm bone (humerus) and the shoulder blade (scapula). These bones are held together by soft tissues, such as tendons, ligaments, joint capsules and muscles, to form a solid platform for the arm to work from.

Three joints make up the shoulder: the glenohumeral joint, the sternoclavicular joint and the acromioclavicular joint. There is also a connection between the shoulder blade and the chest wall, where the shoulder blade glides over the ribs (American Academy of Orthopaedic Surgeons, n.d.-a).

The main joint of the shoulder is the glenohumeral joint. It is made up of a ball sitting on a shallow socket, a bit like a golf ball on a tee. The bones of the shoulder are covered by several layers of soft tissue. The top layer, the deltoid muscle, sits just beneath the skin and gives the shoulder its rounded shape. The deltoid muscle helps to lift the arm. Directly beneath the deltoid is a bursa, which is a fluid-filled sac (American Academy of Orthopaedic Surgeons, n.d.-a).

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat Glenohumeral Joint Instability

1. If You Think Your Shoulder Has Dislocated

A dislocated shoulder needs treatment in hospital. Do not try to put your arm back in yourself, even if it has happened before (NHS, 2026). Call 911 or go to the emergency room at your nearest hospital if you have injured your shoulder and you cannot move your arm, your shoulder looks out of place or has changed shape, or it is painful, bruised or swollen. Don't drive yourself (NHS, 2026).

While you wait for treatment, you can gently hold an ice pack (or a bag of frozen peas wrapped in a tea towel) to the shoulder for up to 20 minutes every 2 to 3 hours, support the arm in a sling or with a towel, and avoid moving your upper arm (NHS, 2026). The NHS (2026) also advises taking paracetamol for the pain while you wait, following the dosage advice on the packet. (This medicine information comes from the NHS, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

2. Hospital Treatment

At the hospital, a doctor will usually check the shoulder with an X-ray and then move the arm back into place, with a local anaesthetic or sedative so you do not feel pain. You will then be given a sling to support your arm (NHS, 2026).

3. Therapy

Strengthening the shoulder muscles and working on shoulder control can increase stability (American Academy of Orthopaedic Surgeons, n.d.-b). I can help with a programme to strengthen your shoulder and improve its control, along with hands-on treatment. See the My Approach tab for how I work.

After the shoulder has been treated, a physiotherapist may recommend regular exercises to reduce pain and stiffness and to make your shoulder muscles stronger, which can reduce the risk of the shoulder dislocating again (NHS, 2026). Avoid activities that bring on your symptoms (American Academy of Orthopaedic Surgeons, n.d.-b).

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Surgery: an operation to repair torn or stretched ligaments and other soft tissues so they can hold the shoulder in place better. It is usually offered to people whose shoulder keeps dislocating or stays unstable despite therapy (American Academy of Orthopaedic Surgeons, n.d.-b). Whether surgery is advised depends on things like your age and how well the shoulder has healed (NHS, 2026).

How I can help (see the My Approach tab)

Strength and shoulder control exercises

Hands-on work for the shoulder, neck and upper back

Taping and a gradual return to sport or lifting

Tips

Dislocations are often caused by a collision, fall or direct blow to the shoulder.
Forcefully bending or twisting the arm can cause it to dislocate and become unstable.
Seizures and electric shocks can cause the shoulder to dislocate backwards (posterior dislocation) (American Academy of Orthopaedic Surgeons, n.d.-a).
Avoid lifting heavy objects if this brings on your symptoms, as it can place strain on the joint and ligaments.
Shoulder blade fractures usually happen along with an injury to the chest (American Academy of Orthopaedic Surgeons, n.d.-a).
Once you have dislocated your shoulder, you may be left with instability, which leaves the shoulder prone to dislocating again. The risk depends on your age and how well the shoulder healed (NHS, 2026).

Treatment

My Approach

An unstable shoulder needs two things: protection while the tissues holding the joint settle, then steady work to make the muscles around it strong and well controlled. If your shoulder has come out and is still out, don't try to put it back yourself: support the arm and call 911 or go to the emergency room. I come in once it's back in place, and if you've had surgery, I need your surgeon's okay before any hands-on treatment.

I start by assessing how your shoulder and shoulder blade move, the strength and control of the rotator cuff and shoulder blade muscles, and the nerves to your arm (feeling, reflexes and strength), without pushing the shoulder into positions that feel unsafe.

Early On: Protecting the Shoulder

Supported positions, with your arm in the sling if you're still using one
Gentle lymphatic drainage for swelling, and massage through the neck, upper back and other arm
Keeping your elbow, wrist and neck moving
Pain-free holds, such as pressing your forearm gently into your belly or a pillow against your side

As It Heals

Trigger point and myofascial work around the shoulder, including the muscles at the front of the shoulder and under the shoulder blade
Chest wall work only when it's clinically relevant, with your informed consent and a signed consent form; armpit work only with your informed consent
Light resistance in safe ranges for the rotator cuff and shoulder blade muscles, building strength before range in the direction it came out
Taping or a basic brace for support during activity, and I'll show you how to tape it yourself

Back to Sport and Lifting

Progressive strength and control work, building to gym-based lifting and sport-specific drills, and a gradual return to the activities that used to bring on your symptoms

Throughout, we avoid the position your shoulder came out in, which for most people is the arm out to the side and turned backward. If the joint is still loose and hasn't been surgically repaired, I don't mobilise the shoulder joint itself.

What to Expect

Typical Course

Typical course: Most people come once or twice a week early on, then weekly as strength builds, then less often, with a reassessment at about 4 to 6 weeks. Returning to sport is often around three to four months, once the shoulder feels stable and strong; after surgery, the timeline follows your surgeon's plan.

What I Focus On

Protecting the Shoulder

Swelling Control

Strength Before Range

Shoulder Control

Gradual Return to Sport

Sources

References

American Academy of Orthopaedic Surgeons (n.d.-a) Shoulder trauma (fractures and dislocations). OrthoInfo. Available at: https://www.orthoinfo.org/en/diseases--conditions/shoulder-trauma-fractures-and-dislocations/ (Accessed: 7 October 2026).
American Academy of Orthopaedic Surgeons (n.d.-b) Chronic shoulder instability and dislocation. OrthoInfo. Available at: https://www.orthoinfo.org/en/diseases--conditions/chronic-shoulder-instability/ (Accessed: 7 October 2026).
NHS (2026) Dislocated shoulder. Available at: https://www.nhs.uk/conditions/dislocated-shoulder/ (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooGlenohumeral Joint Instability

What It Is

Glenohumeral Joint Instability Anatomy

Self-Care & Treatment

How to Treat Glenohumeral Joint Instability

1. If You Think Your Shoulder Has Dislocated

2. Hospital Treatment

3. Therapy

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Early On: Protecting the Shoulder

As It Heals

Back to Sport and Lifting

Typical Course

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooGlenohumeral Joint Instability

What It Is

Glenohumeral Joint Instability Anatomy

Self-Care & Treatment

How to Treat Glenohumeral Joint Instability

1. If You Think Your Shoulder Has Dislocated

2. Hospital Treatment

3. Therapy

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Early On: Protecting the Shoulder

As It Heals

Back to Sport and Lifting

Typical Course

References

Related Conditions

Acromioclavicular Joint Sprain

Biceps Brachii Tendinopathy

Biceps Tendonitis of the Shoulder

Calcific Tendinopathy of the Shoulder

Book a session