Dallas Shoulder Instability Surgeon
Shoulder instability occurs when the ligaments and other soft tissue structures surrounding the glenohumeral joint, a ball-and-socket joint, fail to keep the humeral head (upper arm bone) properly positioned within the glenoid (shoulder socket). This results in subluxation (repeated dislocation) and an unstable shoulder.
This compromised stability leads to excessive movement of the humeral head, resulting in subluxation, which is a partial dislocation where the bone slips out of the socket and returns, or a full dislocation, where the bone completely displaces.
The consequences of this instability extend beyond immediate shoulder pain and discomfort— repeated episodes of subluxation or dislocation can stretch and further damage the surrounding ligaments, labrum, and cause rotator cuff tears. This has the potential to create a cycle of increasing instability and vulnerability to future shoulder injury. Over time, this chronic condition can lead to the development of secondary shoulder conditions, such as early-onset osteoarthritis, as the abnormal joint mechanics cause increased wear and tear on the articular cartilage that normally prevents friction between the moving bones, impairing smooth movement and shoulder function.
With timely treatment, most patients can break this cycle of instability and return to a fully active lifestyle.
Symptoms and Causes of Shoulder Instability
Symptoms include but are NOT limited to: recurrent shoulder dislocations or subluxations, a sensation of the shoulder slipping or feeling loose, pain, weakness, and limited range of motion.
The causes of shoulder instability include: traumatic injuries (e.g., falls, sports injuries), repetitive microtrauma (common in overhead athletes), and congenital ligamentous laxity (inherent looseness of ligaments).
Identifying the cause of instability early gives patients the best chance at a complete, lasting recovery.
How Is Shoulder Instability Diagnosed?
At Steven J. Thornton, MD’s office, diagnosis involves a physical examination, medical history review, and imaging studies such as X-rays, MRI, or CT scans to assess ligament damage, labral tears, and bone abnormalities, to determine if conservative treatment options fail and to facilitate healing through appropriate interventions such as rotator cuff repair or reverse shoulder replacement when necessary.
An accurate diagnosis is the foundation of an effective treatment plan and helps Dr. Thornton match each patient with the right procedure.
The Procedures & Treatment Options
Dr. Steven Thornton, a Dallas shoulder instability specialist, emphasizes a personalized approach to shoulder instability— tailoring treatment to the specific cause, severity, and the patient’s lifestyle. Initial management often involves nonsurgical treatment options like physical therapy, focusing on strengthening the rotator cuff and neuromuscular control to enhance stability of this most flexible joint area. In addition, activity modification is crucial to prevent frequent dislocation, and NSAIDs or steroidal injections may manage pain and decrease swelling in the affected area. In acute cases, sling immobilization allows initial healing by maintaining the shoulder joint in the proper position.
Many patients with first-time or mild instability achieve meaningful improvement through physical therapy and activity modification alone.
Your Dallas shoulder instability doctor can recommend shoulder stabilization surgery to repair torn structures such as the labrum or ligaments, and tighten the joint capsule to secure the humerus (upper arm bone) to the glenoid (socket portion) of the shoulder blade (scapula). Your Dallas shoulder instability doctor has provided the following general guidelines for recovery from shoulder arthroscopy here; however, please follow any specific guidelines from your provider.
Most patients who undergo a Bankart repair can expect to return to sport or full physical activity 4 to 6 months following surgery, depending on the demands of their activity.
Patients who require a Latarjet procedure typically follow a similar recovery timeline, with return to high-demand activity expected between 5 and 7 months following surgery.
Shoulder Instability Surgery: What to Expect
When nonsurgical treatment does not restore stability, Dr. Steven Thornton may recommend surgery. The right procedure depends on the type of instability, the extent of soft tissue damage, and whether bone loss is present. Dr. Thornton uses a personalized approach to match each patient with the most appropriate surgical option.
A Bankart repair is the most common surgery for shoulder instability. It is designed for patients who have torn the labrum, the ring of cartilage that keeps the ball of the shoulder seated in the socket.
During this procedure, Dr. Thornton works through small incisions using an arthroscope, a thin camera, and specialized instruments. He reattaches the torn labrum to the rim of the socket using small anchors. This restores the natural bumper that holds the humeral head in place.
A Bankart repair is best suited for patients with a first-time dislocation or recurrent instability caused primarily by soft tissue injury. It is not recommended when significant bone loss is present on the glenoid or the humeral head.
In patients with large engaging Hill-Sachs defects, Dr. Thornton may also recommend a remplissage procedure performed alongside Bankart repair. This technique fills the defect by securing the posterior capsule and infraspinatus tendon into the humeral head defect, helping reduce the risk of recurrent instability and redislocation in high-risk patients.
When bone loss is a factor, the Latarjet procedure is often the better surgical option. Bone loss can occur after repeated dislocations or a severe first-time dislocation. When too much bone is missing from the socket, a soft tissue repair alone may not provide lasting stability.
The Latarjet procedure transfers a small piece of bone from the shoulder blade, called the coracoid, to the front of the glenoid socket. This rebuilt rim deepens the socket and creates a sling effect using the attached tendons, adding a second layer of stability.
Dr. Thornton chooses the Latarjet procedure when imaging confirms meaningful bone loss or when a prior Bankart repair has failed. The procedure is also performed through a targeted incision using precise surgical technique.
The Role of Bone Loss
Bone loss is one of the most important factors in surgical planning. Dr. Thornton evaluates bone loss carefully using CT scans before recommending a procedure. The amount and location of bone loss help determine whether a soft tissue repair will hold long-term or whether a bone reconstruction is required.
The goal of both procedures is the same: a stable shoulder that allows you to return to the activities you value.
Post-Operative Care
Most patients experience a steady, measurable improvement in strength and stability throughout recovery. By the end of physical therapy, the goal is a shoulder that feels stable, moves well, and supports your return to the activities that matter to you.
What to Eat or Drink Following Your Procedure
There are no restrictions on your diet following the minimally invasive shoulder surgery, which typically involves tiny incisions and the use of tiny surgical instruments, but there are some things you can do to reduce feelings of nausea or digestive discomfort after the surgical procedure:
- For the first few days, stick to light foods, including crackers, plain rice and soup.
- As you feel comfortable, gradually progress to your normal diet, but be mindful of heavy or greasy foods. These can cause stomach upset. Prescription pain medication can make these feelings more intense.
- Keep hydrated by drinking plenty of water or electrolyte drinks.
Caring for Incisions
Your shoulder surgery involves incisions that must be cared for in order to promote healing process and prevent infection.
- You may remove the surgical dressing on the third post-operative day. If minimal drainage is present, apply band-aids or a clean dressing over the incisions and change daily.
- Swelling around the incision site is normal, as is light bleeding. If your dressing becomes saturated, do not remove it. Instead, wrap it in sterile gauze until your Dallas shoulder instability doctor has a chance to examine it.
- You can reduce your infection risk by keeping your surgical site dry. Do not immerse your shoulder in water. Starting 24 hours after shoulder surgery, you can begin taking showers; however, cover your incisions with a waterproof plastic cover to keep the area dry.
- Do not use topical skin products on or around the incision site. Avoid oils, creams and ointments unless they are prescribed by your doctor.
- You may shower on the 3rd post-operative day. No immersion in a bath until given approval by our office.
Pain and Medication Guidelines
*The following are general aftercare guidelines for the use of medications. Your Dallas shoulder instability surgeon will provide specific instructions as they pertain to your health, prescriptions and procedure.
- Local anesthesia (numbing medicine) has been used during your procedure. This will begin to wear off within 6-10 hours. You will likely begin to feel discomfort, and pain typically reaches its peak between day 2-3.
- Take your prescribed pain medication according to the directions on the label. If you continue to experience pain despite narcotic pain medication, contact our office to discuss options.
- Side effects of prescription pain medications vary from person to person, but you may experience drowsiness, nausea and constipation. Resting in a safe, comfortable environment is important in early recovery, and an over-the-counter laxative may help with constipation.
- Some people experience nausea after taking prescription pain medications. If nausea becomes severe or is accompanied by vomiting, contact our office.
- You should not attempt to drive until your doctor clears you. Prescription pain medications can cloud your judgment and slow your reaction time.
- For some patients, blood clots can be a risk when taking prescriptions. Please let your Dallas shoulder instability specialist know if you are at risk of developing blood clots.
Your Mobility Following Shoulder Instability Surgery
- For the first week following discharge, rest with the operative shoulder supported in a sling. You can reduce swelling by slightly elevating your arm. This can be done by placing a pillow under your forearm when seated.
- Keep your sling on and in a secure position for the first 4-6 weeks. Do not remove the sling unless cleared to do so by your doctor.
- Avoid activities that involve reaching across the body or pushing objects. When sleeping, avoid lying on the operative side for the first two weeks following shoulder surgery to prevent further injury or risk factors that could compromise the surgical repair or cause the shoulder to completely dislocate again.
- For the first two weeks, avoid long periods of sitting, especially if it requires overhead motion or places stress on the shoulder joint.
- Do not attempt to drive. In addition to safety concerns involving pain medications, your sling may make it unsafe for you to drive. Your doctor will let you know when it is safe to resume driving.
- You can return to work one week after your shoulder surgery. We encourage you to speak with your workplace to secure accommodations that allow you to work in a sedentary position until cleared for additional duty by your doctor, to ensure a smooth recovery following either closed reduction or open surgery procedures.
Proper Usage of Your Sling
- Wear the prescribed sling at all times, including during sleep. Your sling is designed to stabilize the shoulder joint and protect the repair. If adjustments need to be made to your sling, our office can help.
- Your doctor may allow you to remove your sling for personal hygiene. Follow these instructions only for approved activities.
Use a Cold Pack for Swelling
- The application of a cold pack, ice wrapped in a towel or a cooling device can reduce swelling and pain. Apply cold to the surgical site for 20-30 minutes at a time every 2-3 hours.
- Always place a protective barrier, such as a towel or cloth, between the ice pack and your skin to prevent frostbite.
Movement and Stretching Guidelines
- You can begin small exercises like finger and wrist flexion and extension two days after discharge. You should avoid active shoulder movement or movements that involve resistance.
- Stiffness and mild discomfort in the shoulder area is expected during the early recovery phase. If a specific movement causes severe pain, discontinue that movement and call our office.
- Frequent hand and wrist movements throughout the day can reduce the risk of blood clots and other circulatory issues.
- If you have been ordered to undergo physical therapy, our office can help you coordinate an appointment with a physical therapist.
Why Patients Choose Dr. Thornton for Shoulder Instability
Dr. Steven J. Thornton is a board-certified, fellowship-trained orthopedic surgeon with advanced specialty training in shoulder and sports medicine surgery. He evaluates each patient individually and builds a surgical plan based on your anatomy, activity level, and goals.
Shoulder Instability FAQs Answered by Steven J. Thornton, MD
CALL US IF…
Reach out right away if you notice:
- Severe, persistent pain that does not improve with medication or radiates through your upper arm.
- Fever, chills, infection, redness, off-color discharge.
- Severe swelling, tingling, numbness or skin discoloration, particularly in the hand, fingers or forearm.
- Respiratory distress or chest discomfort.
- Bleeding or persistent fluid leakage at the incision site.
Leave Shoulder Care in the Hands of Our Experienced Dallas Shoulder Instability Surgeon
Contact Dallas shoulder instability specialist Dr. Steven J. Thornton, a board-certified orthopaedic surgeon and fellowship-trained specialist, to learn about effective treatment solutions, including shoulder stabilization surgery, shoulder replacement surgery, and shoulder arthroscopy, and start your journey towards a healthier shoulder with restored full range of motion and strength.
Along with shoulder instability treatment, Dr. Thornton diagnoses and treats tendon disorders, AC joint injuries, frozen shoulder issues, rotator cuff conditions, and shoulder impingement.