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The superior shoulder suspensory complex (S.S.S.C.), a bony/soft tissue structure, is important both for its role as an intact unit and for the individual components that make up this unit. Traumatic “double disruptions” of the S.S.S.C. frequently create an unstable anatomic situation with adverse long-term healing and functional consequences. This “double disruption” principle underlies, unites, and allows one to understand several well-described but difficult-to-treat shoulder injuries that have previously been described in isolation. Injuries to the S.S.S.C. require careful radiologic evaluation for the possible presence of a “double disruption.” If displacement is unacceptable, surgical reduction and stabilization of one or more of the injury sites is necessary.