Recurrent shoulder dislocation

A recurrent shoulder dislocation is the persistent inability to keep the head of the humerus centred in the socket of the shoulder socket after a primary dislocation. This can cause persistent symptoms of pain, instability, weakness, decreased confidence in the shoulder. Promary dislocation follows trauma.

Risk Factors

Some people are born with greater laxity or looseness in their ligaments and can have Atraumatic Shoulder Instability. These people are at greater risk of dislocating their shoulders – Habitual dislocators.

Who to refer, who not to refer, how to refer

Who to Refer

Those who have failed Primary care management

Urgent Referral Criteria

Highly active patient
Neural signs (aux nerve)
Avascular necrosis or bone death
Significant Bone loss of the Glenoid / Humeral Head depression.

Who Not to Refer

Those who have not tried Primary care management

Additional Info

Imaging

Shoulder X-ray (Ideally xray is < 1yr old)
MRI initially – if orthopaedics feel necessary they will order an MRA

How to refer

We accept referrals through SCI gateway for those who are based in Scotland.

We also accept e referrals through the below email address using the attached form for those who are based just on the other side of the border.

E- Referral Email address - bor.orthoreferrals@borders.scot.nhs.uk

Referral form - E-Referral to Orthopaedics (Non Sci-Gateway)

Primary care management

Education
Physio rehab- Patient Specific Physiotherapy - over extended period of time ( at least 6 months)

Resources and links

Primary care shoulder pathway - developed by First Contact Practitioners (To be confirmed, will update when available)

Local service details

orthopaedics@borders.scot.nhs.uk

bor.orthoreferrals@borders.scot.nhs.uk

Last reviewed: 31/07/2025

Next review date: 31/07/2027

Author(s): Mr Roshan Raghavan, Mr Rehan Siddiqi.

Author email(s): Roshan.Raghavan@nhs.scot.