When is physiotherapy recommended for shoulder instability?

Shoulder instability means the joint moves excessively or feels as though it may slip, sometimes after an injury and sometimes because the person has naturally flexible joints. Symptoms can include apprehension with certain positions, clicking, weakness or repeated partial or complete displacement. Assessment helps identify whether the main issue is muscle control, ligament or labral injury, joint shape, or a combination. That distinction affects whether rehabilitation is tried first or combined with specialist care.

Avoid repeatedly testing the unstable position while the shoulder is being assessed. Rehabilitation may begin with low-load exercises for the rotator cuff and shoulder blade, then progress to weight-bearing, reaching and sport or work tasks. A physiotherapist may also teach reaction and coordination drills so the shoulder responds more reliably during movement. Attend follow-up reviews if episodes continue, because repeated slipping can change the plan and may need orthopaedic assessment.

Seek urgent care if the shoulder is currently out of place, has suddenly become very painful, or the hand is cold, pale, numb or weak. Do not attempt a self-reduction. Arrange prompt review for repeated dislocations, increasing weakness, loss of motion or instability after a new injury, even if the shoulder moves back into place.

Ask what may be causing the instability, whether imaging or an orthopaedic opinion is appropriate, and which positions to avoid temporarily. Ask how progress will be judged and when it is safe to return to overhead work, contact activity or sport.