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Shoulder instability

Shoulder Instability & SLAP Lesions

Shoulder instability occurs when the structures that hold the joint together are damaged, allowing the ball to move excessively or dislocate. SLAP lesions affect the superior labrum and biceps anchor, causing pain and dysfunction in overhead athletes.

Prof Paul LeeReviewed byProf Paul LeeLast reviewed 1 May 2026
Shoulder joint anatomy

Causes of shoulder instability

Instability most commonly follows a traumatic dislocation that tears the labrum (Bankart lesion) and stretches the capsular ligaments. Other causes include:

  • Repetitive overhead sport (swimming, throwing, tennis) causing microtrauma to the labrum.
  • Generalised hypermobility leading to multidirectional instability.
  • Bone loss on the socket (glenoid) or humeral head from recurrent dislocations.
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Symptoms and diagnosis

  • Apprehension or fear that the shoulder will slip out during certain movements.
  • Recurrent subluxation (partial slip) or full dislocation events.
  • Deep shoulder pain, particularly with overhead or throwing movements (SLAP).
  • Clicking, catching, or a dead-arm sensation during sport.

Diagnosis combines clinical examination with MRI arthrogram and, where bone loss is suspected, CT scan to quantify the deficiency and plan surgery.

At London Cartilage Clinic, our shoulder specialists assess the full picture, including labral damage, bone loss, and capsular laxity, to determine the most effective stabilisation strategy.

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Specialist examining shoulder

You may have more options than you think

Most patients have more treatment options than they have been told

At London Cartilage Clinic we follow a structured clinical framework across four areas of treatment. Before recommending a single procedure, we assess which combination of approaches gives you the best outcome.

Preserve

Protect what you have. Slow degeneration and manage symptoms.

Repair

Fix specific damage. Torn tissue, unstable joints, structural problems.

Regenerate

Rebuild lost tissue. Biological treatments that stimulate new growth.

Replace

When other options are exhausted. Joint replacement as a last resort.

Explore the full range of treatments available for your joint. Each hub page shows every option we offer, organised by clinical approach.

Explore Shoulder Options
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Frequently Asked Questions

What is shoulder instability?

Shoulder instability means the ball of the humerus moves excessively within or out of the socket. It ranges from a feeling of looseness (subluxation) to full dislocation. It typically results from traumatic injury, repetitive overhead sport, or generalised ligament laxity.

What is a SLAP lesion?

SLAP stands for Superior Labrum Anterior to Posterior. It is a tear at the top of the labrum where the biceps tendon anchors. SLAP lesions are common in overhead athletes and can cause deep shoulder pain, clicking, and a sense of instability during throwing or lifting.

Will my shoulder keep dislocating?

After a first dislocation, the risk of recurrence depends on age, activity level, and the extent of labral and bony damage. Younger patients (under 25) have a significantly higher recurrence rate, which is why early surgical stabilisation is often recommended in this group.

What does surgery for shoulder instability involve?

Arthroscopic Bankart repair reattaches the torn labrum using suture anchors. In cases with significant bone loss, a Latarjet procedure (bone block) may be needed to reconstruct the socket rim. SLAP repairs reattach the superior labrum, though management varies by age and activity demands.

Still have more specific concerns?

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