The first time your shoulder dislocates can be hard to forget.
Maybe it happened during a hockey game, on the ski hill, or after a fall. Once the initial pain settles, it is normal to start wondering: Could this happen again? And do I need surgery?
At Gateway Surgery in Calgary, Alberta, we help patients understand what comes next after a shoulder dislocation, including when surgery may be worth considering.
What Happens After a Shoulder Dislocation?
Your shoulder is a ball-and-socket joint. Because the socket is fairly shallow, it relies on the labrum, ligaments, and surrounding muscles for stability.
During a dislocation, the ball is forced out of the socket, most often toward the front. This can stretch the ligaments and tear the labrum away from the bone. One common injury is a Bankart lesion, where the labrum is torn away from the edge of the socket when it comes out the front.
Early treatment often includes:
- Wearing a sling or brace
- Using ice and pain relief as recommended
- Participating in a gradual rehabilitation program, often supervised by a physiotherapist
Exercises that improve shoulder muscle coordination, strength, and endurance play an important role in restoring function and stability after a shoulder dislocation.
Do All Shoulder Dislocations Need Surgery?
Not necessarily. Many people recover successfully from a shoulder dislocation with physiotherapy and rehabilitation.
However, not everyone achieves a stable, confident shoulder with rehabilitation alone. If symptoms of instability persist or recurrent dislocations occur, surgery may be considered to help reduce the risk of future episodes.
A 2025 position statement from the Arthroscopy Association of Canada, co-authored by Gateway shoulder surgeon Dr. Jarret Woodmass, reviewed the available research on first-time shoulder dislocations. Across the studies included:
- Approximately 51% of patients treated without surgery experienced another dislocation.
- Approximately 6% of patients who underwent an arthroscopic Bankart repair experienced another dislocation.
- Patients who had surgery were also more likely to return to their previous level of sport.
These findings do not mean that everyone requires surgery. Rather, they represent one factor to consider when discussing the treatment option that may be most appropriate for your individual circumstances.
Who Is More Likely to Dislocate Their Shoulder Again?
Certain factors may increase the risk of experiencing another shoulder dislocation, including:
- Being younger when the first dislocation occurred
- Being male
- Participating in contact or collision sports such as hockey, football, or rugby
- Having naturally loose or flexible joints
If you have experienced more than one dislocation, speaking with your doctor about your treatment options may be helpful. An orthopaedic surgeon can help determine whether continued rehabilitation or surgery is most likely to help you achieve your goals and reduce the risk of future instability.
When Should You Consider Surgery?
Surgery is not determined by the number of dislocations alone.
You may want to speak with a shoulder surgeon if:
- Your shoulder has dislocated more than once
- You continue to feel instability despite rehabilitation
- Your shoulder limits work, sports, or daily activities
- You experience apprehension when reaching overhead, throwing, or placing your arm in certain positions
- Imaging shows significant soft tissue injury or bone loss
- You participate in contact or collision sports
- You want to reduce the risk of future dislocations
Recurrent instability is not always limited to repeat dislocations. Some people experience a persistent feeling that the shoulder may slip out of place again, even when a full dislocation does not occur. These symptoms can impact quality of life and athletic performance.
What Surgeries Are Used to Treat Shoulder Instability?
If surgery is recommended, the goal is to improve shoulder stability and reduce the risk of future dislocations.
The procedure that is right for you depends on the structures that were injured, your pattern of instability, your activity level, and any bone loss seen on imaging.
In general, shoulder stabilization procedures fall into two categories.
Soft-Tissue Stabilization
These procedures repair or reinforce the ligaments, capsule, and labrum that help keep the shoulder in place.
Examples include:
- Arthroscopic Bankart repair, which reattaches a torn labrum to the socket using small incisions and a camera.
- Posterior labral repair, which may be used when the shoulder is unstable toward the back.
- Remplissage, which may be added in some cases to address a defect in the humeral head and further reduce the risk of recurrence.
Bony Stabilization
Recurrent dislocations can sometimes damage the bone of the shoulder socket or humeral head, increasing the risk of future instability.
When significant bone loss is present, procedures that restore or augment bone may be recommended.
Examples include:
- Latarjet procedure, which transfers a piece of bone to the front of the socket to improve stability.
- Distal tibial allograft, which uses donor bone to reconstruct areas of socket bone loss.
Your surgeon will recommend the procedure that best matches your anatomy, goals, and risk factors.
For more information, learn about shoulder instability and ligament repair or explore Gateway Surgery’s private shoulder surgery services.
After surgery, Gateway Surgery’s on-call nursing team is available seven days a week from 7 a.m. to 11 p.m. MST for up to eight weeks, providing support throughout your recovery.
Frequently Asked Questions
What Should I Do Right After My Shoulder Dislocates?
If you suspect your shoulder has dislocated, seek medical care as soon as possible. A healthcare professional can assess the injury, determine whether the shoulder is still out of place, check for associated damage, and safely return it to its proper position if needed.
Do not attempt to force the shoulder back into place yourself, as this may cause additional injury.
Do I Need Surgery After a First-Time Shoulder Dislocation?
Not necessarily. Many people recover successfully from a first-time shoulder dislocation with physiotherapy and rehabilitation alone.
Whether surgery is recommended depends on several factors, including your age, activity level, sport participation, shoulder stability, imaging findings, and risk of experiencing another dislocation. An orthopaedic surgeon can help determine which treatment option is most appropriate for your situation.
Will My Shoulder Dislocate Again?
Not everyone experiences another dislocation, but the risk varies from person to person.
Factors associated with a higher risk of recurrence include younger age at the time of the first dislocation, participation in contact or collision sports, naturally loose joints, and previous dislocations. If you are concerned about your risk, a shoulder surgeon can help assess your individual situation and discuss treatment options.
How Do I Know If My Shoulder Is Still Unstable?
Signs of ongoing shoulder instability may include:
- Repeat dislocations or partial dislocations (subluxations)
- A sensation that the shoulder is slipping, shifting, or moving out of place
- Feeling apprehensive when reaching overhead or placing the arm in certain positions
- Difficulty trusting the shoulder during sports, work, or exercise
If these symptoms persist despite rehabilitation, it may be worthwhile to seek an assessment from a shoulder specialist.
What Does a Good Rehabilitation Program Look Like?
A rehabilitation program after a shoulder dislocation should progress gradually based on your symptoms, healing, and goals.
While every program is different, rehabilitation typically focuses on:
- Restoring shoulder range of motion
- Improving rotator cuff strength
- Strengthening the muscles that control the shoulder blade
- Improving coordination and dynamic shoulder stability
- Gradually returning to work, sport, and other activities
A physiotherapist can help design a program that matches your injury, activity level, and recovery goals while monitoring for ongoing symptoms of instability.
When Can I Return to Sports After a Shoulder Dislocation?
The timing of a return to sport varies depending on the severity of the injury, your shoulder stability, and whether surgery was required.
Before returning to sport, you should generally have regained shoulder strength, range of motion, and functional stability. Your physiotherapist, sports medicine physician, or surgeon can help determine when it is safe to resume training and competition.
How Do I Access Private Shoulder Surgery in Canada?
At Gateway Surgery, no referral is required. The team can gather your medical records and connect you with a shoulder surgeon for a virtual or in-person consultation.
You can also read more about what to expect from a consultation.
What Comes Next?
A shoulder dislocation does not automatically mean surgery. The right treatment depends on your injury, your risk of another dislocation, and what you want to get back to doing.
Contact Gateway Surgery to book a consultation and explore your options.
References
- Alberta.ca. Dislocated Shoulder: Care Instructions.Government of Alberta.
https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uf7739 - Abdel Khalik H, Dagher D, Lameire DL, Gusnowski E, Kolpka M, LeBel ME, Matache BA, Martin RK, Sommerfeldt M, Wong I, Woodmass J, Khan M. Management of First-Time Anterior Shoulder Dislocation: A Systematic Review and Meta-analysis. Arthroscopy Association of Canada Position Statement.Orthopaedic Journal of Sports Medicine. 2025;13(2):23259671251316893.
https://doi.org/10.1177/23259671251316893
