I Dislocated My Shoulder a Long Time Ago, and Now My Shoulder Is Sore—What Happened?

When the Past Catches Up

It might have been five years ago, or fifteen, or thirty. Maybe you dislocated your shoulder playing football in high school. Maybe it happened during a skiing accident in your twenties. At the time, someone popped it back in, the pain eventually faded, and you moved on with your life.

Now your shoulder is bothering you again. It aches after activity. It feels unstable sometimes, like it might slip out of place. Maybe it catches or clicks in certain positions.

You find yourself wondering: is this related to that old injury, or is it something new?

In most cases, it's related. Shoulder dislocations—even ones that happened decades ago—can set the stage for long-term problems. Understanding why helps explain what you're experiencing now.

What Happens During a Dislocation

Your shoulder is the most mobile joint in your body, which also makes it the most vulnerable to dislocation. The ball of your upper arm bone sits in a shallow socket on your shoulder blade. Unlike your hip, where a deep socket holds the ball firmly in place, your shoulder relies on soft tissue structures to maintain stability.

When your shoulder dislocates, the ball is forced completely out of the socket. This isn't a gentle process. On its way out, the ball often damages the structures meant to keep it in place.

The labrum—a ring of cartilage that deepens the socket and anchors stabilizing ligaments—frequently tears during dislocation. This injury, called a Bankart lesion, is present in the majority of traumatic dislocations. The ligaments themselves may stretch or tear. The rotator cuff can be injured, especially in patients over forty. Sometimes the ball or socket bones sustain fractures or dents from the impact.

When your shoulder was put back in place, the bones returned to their proper position. But the soft tissue damage often persists. A torn labrum doesn't spontaneously heal back to its original attachment. Stretched ligaments don't automatically tighten. The joint may look normal on the outside while remaining compromised on the inside.

Why Symptoms Can Appear Years Later

If the damage happened during the dislocation, why did your shoulder feel fine for so long?

Young, strong muscles can compensate for structural damage. In your twenties and thirties, robust rotator cuff and shoulder girdle muscles may have provided enough stability to mask underlying problems. As muscle mass and strength naturally decline with age, that compensation becomes less effective.

Arthritis develops gradually. When cartilage is damaged—either during the initial dislocation or from years of abnormal joint mechanics—arthritis can slowly progress. It may take a decade or more for the wear to become symptomatic.

Activity changes matter too. Maybe you stopped playing the sport that caused the dislocation, so you never stressed the shoulder the same way. Now you've taken up pickleball, or you're helping your kids move apartments, or you started a job with different physical demands. The shoulder that managed your routine activities suddenly can't handle new challenges.

Repeated minor instability events cause cumulative damage. If your shoulder has been subtly slipping without fully dislocating, each episode creates a little more wear. A high school teacher from Farmington described feeling her shoulder "shift" when reaching for high shelves over the years. Each shift was causing incremental damage she couldn't see or feel at the time.

Conditions That Develop After Dislocation

Several specific problems commonly emerge years after a shoulder dislocation.

Post-traumatic arthritis develops when the initial injury damages cartilage or when altered joint mechanics cause accelerated wear. The smooth surfaces that allow bones to glide painlessly become rough and irregular. Pain, stiffness, and grinding sensations follow.

Chronic instability occurs when the labrum and ligaments never heal properly. The shoulder may dislocate again with minimal force, or it may sublux—partially slip out of place—during normal activities. Some patients describe feeling like they can't trust their shoulder.

Rotator cuff tears can be directly caused by dislocations, particularly in older patients. Even if the cuff survived the initial injury, years of abnormal mechanics can lead to accelerated tendon breakdown.

A combination of these issues often coexists. A ski patroller from Purgatory came to see me with shoulder pain that had gradually worsened over several years. His MRI showed arthritis from a dislocation fifteen years earlier, plus a partial rotator cuff tear that had developed more recently. His old injury had set off a cascade of problems.

How to Know What's Happening Now

Evaluating a shoulder with a remote dislocation history involves piecing together a timeline. When did the dislocation occur? How was it treated at the time? Have there been subsequent dislocations or instability episodes? When did current symptoms begin, and what makes them better or worse?

Physical examination reveals a lot. Specific tests can identify instability, rotator cuff weakness, and signs of arthritis. X-rays show bone structure, joint spacing, and arthritic changes. MRI provides detail about the labrum, ligaments, and rotator cuff.

Sometimes we find exactly what we expected based on history. Other times imaging reveals surprises—damage that was worse than anticipated, or an unrelated new problem coexisting with the old injury.

Treatment Depends on the Diagnosis

What we do next depends on what we find.

Post-traumatic arthritis in a younger patient presents a challenge because shoulder replacement, while highly effective, has a limited lifespan. We often try to manage symptoms with activity modification, physical therapy, injections, and anti-inflammatory medications for as long as possible. When arthritis becomes severe enough, joint replacement can be transformative.

Chronic instability in an active person often benefits from surgical stabilization. Arthroscopic procedures can repair the torn labrum and tighten stretched ligaments. For patients with significant bone loss from repeated dislocations, more complex reconstructive procedures may be necessary.

Rotator cuff tears are evaluated and treated based on their size, the patient's symptoms, and functional demands—similar to tears that occur without a dislocation history.

Physical therapy plays a role in nearly every scenario. Strengthening the muscles that support and control the shoulder can improve function and reduce pain regardless of the underlying structural problem.

The Importance of Not Ignoring It

Some patients assume that because their shoulder "held up" for years after a dislocation, whatever's happening now must be minor. That's not necessarily true. Problems that have been silently progressing can reach a point where they cause rapid decline.

More importantly, some conditions are easier to treat earlier. A labral repair is more straightforward before significant cartilage wear develops. Managing early arthritis can delay the need for joint replacement. Addressing instability prevents the cumulative damage of repeated subluxation episodes.

A hunting guide from Cortez waited two years after his symptoms started because he assumed the discomfort was just "old age." By the time he came in, his arthritis had progressed significantly. He's doing fine now, but he wishes he'd been evaluated sooner.

Connecting Past and Present

That dislocation you experienced years ago isn't ancient history to your shoulder. The joint remembers the injury even if you've mentally filed it away. Recognizing the connection between past trauma and present symptoms is the first step toward understanding what's happening and what can be done.

Your shoulder served you well for years after that injury. The fact that it's now causing problems doesn't mean you did anything wrong—it means the accumulated effects of that original damage have finally become symptomatic. Let's figure out exactly what's going on and how to help you move forward.

You can email Doctor Butzen at doctorbutzen@gmail.com if you have questions. He may request an office visit for complex concerns that require face-to-face discussion.