Dislocations & Labral Tears
Shoulder Instability & Labral Repair in Glendale, AZ
Shoulder instability means the ball of the joint slips partly or fully out of the socket. It usually starts with a dislocation and can lead to repeat dislocations, labral tears, and, over time, arthritis. Dr. James MacKenzie treats dislocated and unstable shoulders in Glendale, Arizona with rehabilitation first and arthroscopic stabilization when it is needed. Having served as an assistant team physician in the NFL and NBA and provided coverage for NHL, MLS, and collegiate teams, he has cared for shoulder instability at every level, from high school athletes to adults injured in a fall.
Why patients choose Dr. MacKenzie
- Board-certified orthopedic surgeon
- Fellow, American Academy of Orthopaedic Surgeons (FAAOS)
- Johns Hopkins residency, sports medicine fellowship
- Former assistant team physician, Miami Dolphins & Miami Heat
- Nonsurgical options first, surgery only when needed
- Se habla español
Why Shoulders Dislocate
The shoulder trades stability for motion. The socket is shallow, and a rim of cartilage called the labrum, together with the ligaments and rotator cuff, keeps the ball in place. A hard fall, a collision, or a wrenching arm-over-head injury can force the ball out, tearing the labrum and stretching the capsule. Once those restraints are damaged, the shoulder is more likely to slip again, particularly in younger, active people.
Dislocation, Subluxation, or Separated Shoulder?
These get mixed up often. A dislocation means the ball has come fully out of the socket and usually needs to be put back in place. A subluxation is a partial dislocation: the ball slips part of the way out and returns on its own, often with a sense that the shoulder “popped.” Both are forms of instability. A separated shoulder is a different injury altogether, involving the ligaments where the collarbone meets the shoulder blade (the AC joint), and is covered on our fracture and injury care page.
Types of Shoulder Instability
Traumatic anterior instability is the most common, following a dislocation toward the front. Posterior instability is less common and often develops from repetitive pushing or a fall. Multidirectional laxity means the shoulder is loose in several directions and is usually treated without surgery. SLAP tears involve the top of the labrum where the biceps attaches and are common in throwing and overhead athletes.
Nonsurgical Care After a Dislocation
After a first dislocation, treatment usually starts with a short period in a sling followed by physical therapy to strengthen the rotator cuff and shoulder-blade muscles that dynamically stabilize the joint. Many patients, particularly those over 40 or with multidirectional laxity, do well without surgery. Dr. MacKenzie’s first instinct is the least invasive option that will get you back to what you do.
When Surgery Is Recommended
Repeated dislocations, a first dislocation in a young athlete who plays a collision or overhead sport, a labral tear that keeps catching or slipping, and instability with bone loss from the socket rim are the usual reasons to consider surgery. Imaging, typically an MRI arthrogram and sometimes a CT scan to measure bone loss, guides the decision.
Arthroscopic Labral (Bankart) Repair
The most common stabilization procedure is an arthroscopic Bankart repair. Through small incisions, Dr. MacKenzie reattaches the torn labrum to the rim of the socket with suture anchors and tightens the stretched capsule as needed. When a significant amount of bone has been lost from the socket, a bone-block procedure may be recommended instead so the repair holds. Surgery is outpatient and takes about an hour.
Recovery and Return to Sport
Expect a sling for roughly four weeks, protected motion after that, strengthening by about three months, and a gradual return to sport, usually five to six months for contact and overhead athletes. Return is based on meeting strength and control criteria rather than the calendar. Timelines vary by patient. Individual results vary.
Risks
Risks include infection, stiffness, recurrent instability, nerve injury, and the risks of anesthesia. Recurrence is more likely in young contact athletes and when bone loss is present. Dr. MacKenzie reviews these with every patient. Individual results vary.
Questions
Frequently Asked Questions
Don’t see your question here? Our team is happy to help.
Will my shoulder dislocate again?
The risk depends heavily on your age at the first dislocation and your activities. Teens and athletes in contact or overhead sports have the highest recurrence rates, while patients over 40 more often stabilize with therapy. An evaluation gives you a realistic picture.
What is a Bankart repair?
A Bankart repair reattaches the torn front-lower portion of the labrum to the socket rim, usually arthroscopically with suture anchors. It is a standard procedure for recurrent anterior shoulder dislocations when bone loss is limited.
Do I need surgery after one dislocation?
Not necessarily. Many first-time dislocations are treated with a sling and therapy. Surgery is more likely to be recommended for young athletes or when imaging shows significant labral or bone injury.
How long until I can play sports again?
Many athletes return to sport five to six months after labral repair, once strength and control have recovered.
Schedule a Consultation with Dr. MacKenzie
Call the office or request an appointment online and our team will help you take the next step.