Shoulder Instability: Why does your shoulder feel like it is giving way?
Does your shoulder feel like it might slip out, click, or “give way” even though you've never injured it? It is possible you may have atraumatic shoulder instability.
Atraumatic shoulder instability develops gradually, usually from a recent increase in load. It often occurs because the shoulder is naturally more mobile or the muscles that stabilise the joint aren't working together as effectively as they should.
Symptoms:
- A feeling of looseness or instability, that may feel like it might “pop out”
- Clicking or clunking
- Pain with overhead movement or in weight bearing positions
- Weakness or fatigue during activity
Symptoms are different between each individual, and some may not experience any pain.
What causes it?
The shoulder is designed to move more than any other joint in the body, with more mobility it generally comes with less stability.
Factors that can contribute include:
- Hypermobility
- Reduced control of the shoulder and shoulder blade muscles
- A recent increase in repetitive overhead sports or activities, such as swimming, tennis, volleyball or gymnastics
Can physiotherapy help?
Yes! Physiotherapy is the first-line treatment for most people with atraumatic shoulder instability. Treatment focuses on improving the way the muscles around your shoulder work together, rather than simply making them stronger. Your physiotherapist will guide you through exercises to:
- Improve shoulder control and shoulder blade stability
- Strengthen the rotator cuff, surrounding musculature and build to overhead positions
- Adjustment of current sporting or current loads - taping can assist with keeping up training
- Gradually return back into participating into the sport you love competing
Recovery does take a bit of time, but with a consistent exercise program, many people regain confidence and return to their normal activities without surgery.
What about surgery?
Most people do not require surgery. Physiotherapy is usually very effective, especially when symptoms are related to muscle control rather than structural damage.
When should I see a physiotherapist?
If your shoulder regularly feels loose, unstable, painful, or limits your daily activities or sport, it's worth having it assessed. Early treatment can help improve shoulder stability, reduce symptoms, and prevent ongoing problems. There is evidence for exercise for shoulder conditions, especially for atraumatic shoulder instability - with the use of the Watson instability program.
Summary
Atraumatic shoulder instability is common, particularly in people with naturally flexible joints or those involved in overhead sports with a recent increase in load. A tailored physiotherapy program can improve shoulder control, reduce symptoms, and help you return to the activities you enjoy.
If you would like help with your shoulder pain, please reach out to our team who can assess and help! Call 9313 3414 or book online now!
Website: https://www.backinmotion.com.au/como
Phone Number: 9313 3414
This blog is written by Mathew Piccoli, Senior Physiotherapist at Back In Motion Como
References:
Warby, S. A., Ford, J. J., Hahne, A. J., Watson, L., Balster, S., Lenssen, R., & Pizzari, T. (2017). Comparison of 2 exercise rehabilitation programs for multidirectional instability of the
glenohumeral joint: a randomized controlled trial. The American Journal of Sports Medicine, 46(1), 87-97. https://doi.org/10.1177/0363546517734508
Watson, L., Balster, S., Warby, S., Lenssen, R., Hoy, G., Barwood, S., French, J., Kerr, B., Lawrence, S., Ganderton, C., Davis, K., & Pizzari, T. (2025). The efficacy of conservative
management of micro-traumatic posterior shoulder instability. JSES International, 9(1), 45-66. https://doi.org/10.1016/j.jseint.2024.09.016