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Shoulder Instability

Shoulder-Dislocation_1Diagnoses: Shoulder instability occurs when the head of the humerus separates from the socket. Once the tissues stabilizing the humerus in the socket become stretched, the structure becomes less stable resulting in increased likelihood of future dislocations or subluxations.

Symptoms: Common symptoms of chronic shoulder instability include:

  • Pain following a shoulder injury
  • Repeated dislocations or subluxations of the shoulder
  • Repeated episodes of shoulder giving way
  • Sensations of the shoulder feeling unstable or “loose”

Causes: Potential causes of shoulder instability include:

  • Shoulder dislocation: Dislocation occurs when the head of the humerus pulls away from the shoulder socket. It typically occurs with trauma or injury to the shoulder. Once a shoulder dislocates the likihood of future dislocations increases due to laxity of the joint.
  • Repetitive strain: Joint laxity can also be the result of repetitive overhead motions. Sports such as swimming, tennis, volleyball, and baseball can stretch out the shoulder ligaments resulting in a less stable joint.
  • Multidirectional instability: Ligament laxity and instability might also be present at birth. These patients have naturally loose ligaments and are typically present throughout the body.
  • After a stroke or any paralysis of the arm subluxations are frequently seen due to the muscles inability to contract.

Our Physical Therapy Treatment:

Goals of physical therapy will ultimately be to reduce pain, restore normal pain free range of motion, stabilize the shoulder, and allow for a safe return to all functional and leisure activities. Length of treatment and plan of care will depend on the severity of the injury, but will most commonly include:

  • Mechanical diagnoses/treatment for improved movement and pain reduction
  • Isometric exercises
  • Postural education and awareness
  • Shoulder and scapular stability and strengthening exercises
  • Manual therapy

Treatment will focus on educating the patient in an individualized self-treatment plan and establishing a home exercise program to further promote healing and prevention of future injury.

http://orthoinfo.aaos.org/topic.cfm?topic=a00529