Disclaimer: This article is for general educational purposes only and does not constitute medical advice. Always consult a qualified health professional for advice specific to your condition. © 2026 Better Physiotherapy Bundoora.
The shoulder is the most mobile joint in the body — and pays for that mobility with inherent instability. When the stabilising structures are damaged or deficient, physiotherapy is the first-line treatment for most presentations, reducing redislocation risk and restoring confidence in the shoulder.
Types of Shoulder Instability
Traumatic unidirectional instability (TUBS): Typically anterior, following a specific traumatic dislocation event. Structural damage (Bankart lesion) is common. High redislocation rate in young athletes without adequate rehabilitation. May require surgical stabilisation in high-risk individuals.
Atraumatic multidirectional instability (AMBRI): Generalised ligament laxity, often bilateral, without a specific injury. Common in young hypermobile individuals. Responds very well to conservative rehabilitation. Surgery is almost never appropriate.
Posterior instability: Less common — often seen in overhead athletes (swimmers, cricket bowlers) and in contact sport from a blow to an outstretched arm. Can be subtle and is often missed.
Physiotherapy Rehabilitation After Dislocation
- Phase 1 (Weeks 0–3): Sling, pendulum exercises, gentle passive range of movement. Avoid positions that recreate the dislocation (arm above shoulder height, externally rotated).
- Phase 2 (Weeks 3–8): Progressive active range of movement, rotator cuff isometric and isotonic strengthening, scapular stabilisation.
- Phase 3 (Weeks 8–16): Full range strengthening, sport-specific loading, overhead activities, proprioception training.
- Phase 4 (Months 4–6): Return to contact sport with objective testing criteria.
Surgery vs Conservative Management
Surgical stabilisation (arthroscopic Bankart repair) is most strongly indicated for young athletes (under 25) in collision sports who have had a traumatic anterior dislocation. Redislocation rates in this group can exceed 70% without surgery. For older patients, first-time dislocators in lower-risk sports, and those with atraumatic instability, conservative physiotherapy should be the primary treatment.
Shoulder Instability Treatment at Better Physiotherapy Bundoora
We provide comprehensive post-dislocation and instability rehabilitation for athletes and recreational patients. Call (03) 9467 6900 or book online.
Frequently Asked Questions
What happens when a shoulder dislocates?
A traumatic anterior shoulder dislocation (the most common direction) stretches or tears the anterior capsule and labrum (the Bankart lesion). The humeral head may also cause a compression fracture on the posterior humeral head (Hill-Sachs lesion). Nerve injury (axillary nerve) can cause temporary numbness or weakness around the shoulder. After relocation, the structural damage determines the risk of redislocation.
How long does it take to recover from a shoulder dislocation?
Initial immobilisation in a sling for 2–4 weeks is typical, followed by 3–6 months of physiotherapy rehabilitation. Return to contact sport requires full strength and successful sports-specific testing. Young athletes (under 25) in collision sports have very high redislocation rates (50–90%) and may be offered surgical stabilisation (Bankart repair) earlier than older patients.
What is multidirectional instability (MDI)?
MDI is generalised shoulder laxity in multiple directions (anterior, posterior, and inferior), typically in hypermobile individuals. Unlike traumatic instability, there is usually no history of dislocation. MDI responds best to a conservative rehabilitation program focusing on rotator cuff and scapular strengthening — surgery is rarely appropriate and often produces poor outcomes in this group.
What exercises help shoulder instability?
The rotator cuff muscles (supraspinatus, infraspinatus, teres minor, subscapularis) are the primary dynamic stabilisers of the glenohumeral joint. Strengthening these — along with serratus anterior and lower trapezius for scapular control — is the cornerstone of instability rehabilitation. Neuromuscular retraining exercises that challenge proprioception and co-contraction are equally important.
Ashley Haleel
Physiotherapist & Owner — Better Physiotherapy Bundoora