A shoulder subluxation occurs when the ball of the upper arm bone (humerus) partially slips out of the shoulder socket (glenoid). Unlike a complete dislocation, a subluxation often spontaneously reduces, meaning the joint slips back into place quickly. While acute symptoms may improve over days or weeks, the underlying structural damage to the joint’s stabilizing tissues usually does not heal completely without targeted intervention. Long-term shoulder health depends on addressing the resulting mechanical instability rather than the immediate resolution of pain.
Understanding the Injury: Subluxation vs. Dislocation
A subluxation is a partial separation of the joint surfaces where the humerus remains in contact with the glenoid. The feeling is often described as the shoulder “giving out” or “slipping” before popping back in. A full dislocation, in contrast, involves the complete separation of the ball from the socket, typically requiring a medical professional to reposition the joint.
Even when the joint slips back into alignment, the forceful shift causes damage to the soft tissues responsible for stability. These tissues include the glenoid labrum, the surrounding ligaments, and the joint capsule. Because the shoulder is the most mobile joint in the body, it relies heavily on these soft tissues, rather than bony constraints, for its stability.
The Limits of Self-Healing and Recurrence Risk
While initial pain and inflammation may lessen significantly with time and rest, the resulting structural instability often remains. The perception that the shoulder is “healed” because acute symptoms have disappeared is misleading. The ligaments and joint capsule, stretched or partially torn during the subluxation, may remain lax and weakened.
This lingering laxity makes the joint prone to future episodes, a condition known as chronic shoulder instability. Relying only on rest significantly increases the risk of a recurrent subluxation or a full dislocation. The prognosis for spontaneous recovery is low; one study noted that only about 20% of patients with atraumatic subluxation experience spontaneous recovery.
The risk of recurrence is especially high in younger patients. Their stronger, more elastic ligaments tend to be stripped off the bone rather than tearing, which prevents correct healing. With each subsequent episode of instability, there is a cumulative risk of further damage to the joint cartilage and surrounding structures. This repeated trauma can eventually lead to chronic pain, weakness, and the premature development of shoulder osteoarthritis.
Necessary Steps for Long-Term Shoulder Stability
Achieving full, stable recovery requires a professional assessment and a structured rehabilitation plan. Initial management involves reducing inflammation and pain, often with rest, ice, and temporary immobilization in a sling for one to two weeks. The focus must then quickly transition to restoring the shoulder’s mechanical integrity.
Physical therapy is the cornerstone of non-surgical recovery. It aims to compensate for damaged passive stabilizers (ligaments and capsule) by strengthening dynamic stabilizers (muscles). A physical therapist designs an exercise program targeting the rotator cuff and scapular stabilizers. Strengthening these groups helps keep the humeral head centered within the socket, promoting stability and preventing further subluxation episodes.
This rehabilitation includes exercises to improve neuromuscular control, teaching muscles to activate properly in response to movement. While physical therapy is highly effective, severe instability involving significant labral or ligament tears may require surgical intervention. Regardless of whether treatment is surgical or non-surgical, dedicated rehabilitation is necessary to restore the joint’s function and control.