Dear Katie,

I often get the question “what is shoulder instability?” from patients. Shoulder instability occurs when the ligaments that support the ball and socket joint stretch out. Sometimes this manifests itself as pain or symptoms of the shoulder coming out of its socket. Other times, instability may cause a secondary impingement where rotator cuff tendons that run under the shoulder blade become irritated and painful. The tendons rub against the shoulder blade because of the excessive looseness in the shoulder. Shoulder instability in swimmers, and in your daughter’s scenario, is most likely instability and secondary impingement that has been caused by the overuse of the shoulder. Shoulder instability in swimmers is pretty common. Because she has been swimming for many years it is likely that the ligaments that hold the shoulder in place have become stretched and the muscles and tendons that stabilize the shoulder have become weak over time due to the repetitive nature of swimming.

The simplest treatment for this is avoiding the motion or activity that causes the pain. Of course this is not the option for your college athlete. A careful evaluation with a sports medicine or shoulder specialist is important. Treatments for this injury depend upon the severity of the injury.

Treatments include:

• Painkillers or Anti-Inflammatory Medications
• Physical Therapy
• Steroid Injections
• Arthroscopic Shoulder Surgery

Your best option is to seek an evaluation with a specialist who can discuss the situation, diagnosis, and best treatment for your daughter. If arthroscopic shoulder surgery is the recommended course of treatment, there are new techniques available today for those suffering from shoulder instability.

Best,

Dr. Millett