The shoulder fully dislocating, needing to be put back either by you or by someone else.
A sense that the shoulder is about to come out — apprehension — particularly when reaching behind you or overhead.
The shoulder slipping and self-correcting, which is a subluxation rather than a full dislocation.
Pain and a dead, heavy feeling in the arm after an episode.
Avoiding specific positions without consciously deciding to.
Clicking or catching inside the joint.
Weakness or a sense of the arm not being trustworthy for throwing or lifting.
Why it happens
A fall onto an outstretched hand, or onto the shoulder itself.
A tackle or collision with the arm out to the side and turned outwards — the classic dislocating position.
Reaching backwards forcefully, or a heavy pull on the arm.
Overhead sport with repeated stress: bowling, throwing, volleyball, swimming.
Naturally loose ligaments, where dislocation happens with much less force and often affects both shoulders.
A previous dislocation, which is by far the strongest predictor of the next one.
In some patients, abnormal muscle patterning rather than any structural damage.
See someone sooner if…
The shoulder is currently dislocated — this needs reducing today, and should not be forced by an untrained person.
The arm is numb, cold, weak or pale after an episode, which needs urgent assessment.
You are under 25 and have had a first traumatic dislocation, since the recurrence risk in this group is high and early treatment changes the options.
You are over 40 and have dislocated, because the rotator cuff is frequently torn at the same time and needs assessing.
The shoulder is dislocating repeatedly, as each episode can remove bone and narrow your surgical options.
Why the shoulder is the joint that dislocates
The shoulder has more range of movement than any other joint in your body, and it pays for that with stability. The ball is large; the socket is small and almost flat — imagine a golf ball resting on a tee. What keeps it in place is a rim of tough cartilage around the socket edge called the labrum, together with the ligaments that attach to it and the muscles that hold the ball centred.
When a shoulder dislocates, the labrum is usually torn off the front of the socket, taking the ligaments with it. That leaves a channel. The ball has found a way out, and it will find it again.
Your age changes the advice completely
The same injury needs different treatment at different ages, and this is one of the clearest examples in orthopaedics of why generic advice fails.
Aspect
Under 25
25 to 40
Over 40
Chance of it happening again
High — roughly one in two, higher in contact athletes
Moderate
Low
What is usually torn
Labrum, off the front of the socket
Labrum
Often the rotator cuff, as well as or instead of the labrum
Usual first advice
Discuss stabilisation early, especially for contact sport
Depends on sport, work and how it happened
Assess the rotator cuff — that is often the real problem
Physiotherapy alone
Often insufficient in athletes
Reasonable first step for many
Usually the right treatment
First traumatic dislocation, by age.
For a 19-year-old kabaddi player, waiting for a second, third and fourth dislocation before acting is a decision with a real cost. For a 55-year-old who fell once on a wet floor, stabilisation surgery would be an overreaction — but a missed rotator cuff tear would be a genuine miss.
Two different problems that look similar
Traumatic instability
One clear injury tore the labrum off the socket. Usually one shoulder only, with a definite mechanism. There is structural damage, and repairing it is what restores stability. Physiotherapy improves control but cannot reattach the rim.
Atraumatic instability
Naturally loose ligaments, often affecting both shoulders and sometimes other joints too, with no real injury. Here surgery is usually the wrong answer, and a dedicated programme retraining the rotator cuff and shoulder blade muscles is genuinely the better treatment.
How it is assessed
Your history: how the first episode happened, how many there have been since, and how little force the recent ones needed.
Examination for apprehension and relocation signs, and a check for general joint laxity elsewhere in the body.
X-rays, which can show a chip off the socket rim or a dent in the ball.
MRI, which shows the labral tear, the ligaments and the rotator cuff.
CT, where there have been several dislocations — it measures socket bone loss precisely, and that measurement decides between a keyhole repair and a Latarjet.
First, without surgery
What to try before an operation
This list comes first on purpose. For most people reading this page, it is the whole treatment — and where it is not, having genuinely worked through it makes the decision to operate a much clearer one.
A structured programme strengthening the rotator cuff and the muscles that control the shoulder blade — the foundation of treatment for every type of instability.
Proprioceptive and control work, teaching the shoulder to hold the ball centred automatically.
Avoiding provocative positions during the rehabilitation period: reaching behind, and overhead throwing.
A short period in a sling immediately after a dislocation, for comfort rather than as a cure.
Sport-specific retraining of technique, which for throwers and bowlers can meaningfully reduce recurrence.
Taping or a brace for confidence during a return to sport, understanding that neither repairs the labrum.
For atraumatic instability, three to six months of committed strengthening before surgery is even discussed.
If surgery is needed
And when it genuinely is
Each option below says when it applies, not just what it is. If your situation does not match, that is a good reason to ask more questions.
“By the fourth time, my shoulder was coming out when I turned over in bed. I had been told to strengthen it, and I did, but it kept happening. A CT scan showed I had lost bone from the socket, which is apparently why the simpler operation would not have held.”
Jignesh R., 21 · Kabaddi player
Navsari · 16 months after treatment
Outcome. Latarjet procedure for recurrent dislocation with significant socket bone loss. Out of the sling at four weeks, cleared for contact sport at six months, no further dislocations.
A consultation means your imaging on the screen, a plain explanation of what is actually wrong, and an honest opinion on whether you need surgery — including when the answer is no.