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Helping your dog with
Shoulder Instability

Medial Shoulder Instability (MSI), or subluxation of the shoulder joint, occurs when the medial glenohumeral ligament, the subscapularis tendon or the shoulder joint capsule get inflamed and become progressively more lax.

Medial Shoulder Instability Overview

Signs of MSI

Physical signs of atrophy (wastage) of the shoulder muscles of the affected limb, as well as pain at shoulder joint manipulation are common. Often a history of chronic lameness is present, which is often subtle and intermittent but can be severe and continuous.

Causes of MSI

This condition affects both large and small breed dogs. In larger breed dogs, it is generally thought to be secondary to repetitive microtrauma (overuse), whereas congenital laxity is considered  more likely in small/toy breeds

Treatment of MSI

Unfortunately, dogs tend to respond poorly to easy interventions like anti-inflammatory drugs (NSAIDs). Some dogs may be advised for surgery by their vet where they can re-stabilise the shoulder joint, or in severe cases, fuse the shoulder joint completely. Rehabilitation is vital to restore function as much as possible, and maintain as much comfort as possible as some dogs have ongoing lameness.

What can we do about it?

Plenty! We have numerous modalities in clinic that we have at our finger tips to help your dog. These include massage, soft tissue mobilisation, stretching, joint mobilisations, targeted exercises, laser therapy, hydrotherapy... shall we continue? These have all been shown to maintain muscle function, strength and coordination and get back to competitive fitness. With each session they undergo constant review of their clinical signs and progression in order to gain maximum recovery at a pace that's comfortable for them.


We have a comprehensive programme tailored for your dog's specific needs, depending on their recovery so far.  We will always assess their pain levels (if any), degree of mobility, muscle strength, amongst more, to enable us to create the most successful treatment plan for them. If they have co-morbidities such as Osteoarthritis we will rehabilitate these concurrently.

Alongside what we do with your beloved pooch, there are a number of things outside of the clinic that can help them manage their condition or rehabilitation. Please find information in the sections below!  

Your dog may benefit from a shoulder brace to help keep the joint stable and reduce further damage. Please click here to find recommended braces and more info.

Home Modifications


Wooden floors and stairs are a big slip hazard for your dog. Try using non-slip mats along the main routes of your house. Alternatively, some dogs may benefit from paw pads (please speak to us before trying this option in case of contraindication).

Feeding Stations

Raising their water and food bowls may seem like a insignificant change to us, but it can really help your dog to be in a more neutral position.

Access to Furniture

Jumping up and down from heights if often a cause of additional pain / difficulty to your dog. If they enjoy a cuddle on the sofa or the bed, make it easier for them with dog-friendly steps or ramps onto furniture. This also applies to getting in / out of cars! You may find a sling to be useful.

Keeping Warm

Especially important in the colder months, your dog will benefit from staying warmer. Keep them in a jumper and walk them out with coats. Stay dry too!

Sleeping / Resting Areas

Great quality sleep is essential. Ensure their sleeping area is free from any drafts and in a warm spot. Their bedding should be supportive and not restrictive. Memory foam mattresses without rigid or tall sides are best. Make sure your dog can access the bed and can change position / stretch out easily.

Be Wary of Terrain

Different types of terrain in the garden and on walks can be hazardous, such as steep slopes, loose or uneven surfaces. Be mindful to where they are going.

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