The Orthobullets Podcast Foundations | Shoulder & Elbow | Posterior Shoulder Instability & Dislocation
Dec 16, 2025
Dive into the fascinating world of posterior shoulder instability and dislocation, exploring its rarity and the often missed diagnoses. Discover key risk factors, from bony anomalies to trauma, and hear about classic presentations in athletes. The discussion on imaging highlights crucial views, including the light bulb sign and the Valpo alternatives. Learn about both nonoperative management strategies and advanced surgical options for severe cases, and enjoy real-case scenarios that illuminate the diagnostic challenges and successful treatment outcomes.
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Posterior Instability Is Often Overlooked
- Posterior shoulder instability is less common than anterior but is much more frequently missed on diagnosis.
- Chronic cases require provocative tests and MRI to confirm posterior labral pathology.
Trauma Versus Microtrauma Causes
- Trauma causes most posterior dislocations, while repetitive microtrauma causes posterior instability.
- Seizures and electric shock can also produce posterior dislocations via violent muscle contraction.
Pain Over Instability In Presentation
- Posterior instability often presents with pain rather than a sense of giving way, unlike anterior instability.
- It commonly affects athletes who repetitively push with the arm in forward flexion and internal rotation.