Anterior Shoulder Instability

Anterior shoulder instability refers to a condition in which the upper arm bone (humerus) partially or completely dislocates from the shoulder blade (scapula) at the front of the shoulder joint. It is characterized by frequent episodes of dislocation, subluxation (partial dislocation), or a sense of looseness in the shoulder.

The following are some technical terms associated with anterior shoulder instability:

Glenohumeral joint: The main joint in the shoulder, which is formed by the humerus and scapula bones.

Labrum: A ring of fibrocartilage that surrounds the glenoid cavity and helps to deepen the socket, providing stability to the joint.

Bankart lesion: A tear of the labrum and the anterior portion of the glenoid that occurs as a result of an anterior shoulder dislocation.

Hill-Sachs lesion: A deformity of the humeral head that occurs as a result of contact with the glenoid rim during an anterior shoulder dislocation.

Instability: The inability of the humeral head to remain in the glenoid cavity, leading to subluxation or dislocation.

Subluxation: A partial dislocation, in which the humeral head partially comes out of the glenoid cavity.

Dislocation: A complete separation of the humeral head from the glenoid cavity.

These technical terms are associated with anterior shoulder instability, a condition that can cause significant pain, weakness, and loss of function in the affected shoulder. An accurate diagnosis and appropriate treatment plan can be determined only after a thorough evaluation by a healthcare professional.

Causes of Anterior Shoulder Instability

Anterior shoulder instability can be caused by a variety of factors, including traumatic injury, overuse, and congenital factors. Some common causes of anterior shoulder instability include:

Traumatic injury: An acute injury, such as a fall onto an outstretched arm, can cause the humeral head to partially or completely dislocate from the glenoid cavity. This can result in damage to the labrum and other stabilizing structures in the shoulder, leading to instability.

Overuse injuries: Repetitive overhead activities, such as throwing a ball, can lead to wear and tear on the shoulder joint and surrounding structures, leading to instability.

Congenital factors: Some people may be born with a shallow glenoid cavity, which can make the shoulder joint inherently unstable.

Multidirectional instability: Some individuals may have a naturally loose and hypermobile joint, which can lead to instability in multiple directions.

Weak rotator cuff muscles: The rotator cuff muscles are responsible for stabilizing the shoulder joint. Weakness in these muscles can lead to instability.

These are some of the common causes of anterior shoulder instability. It’s important to note that each individual may have unique factors that contribute to their instability, and an accurate diagnosis can only be made by a healthcare professional after a thorough evaluation.

Signs and Symptoms of Anterior Shoulder Instability

Anterior shoulder instability can cause a variety of symptoms, including:

• Pain: Pain in the front of the shoulder, especially during activities that put stress on the joint, such as lifting or reaching overhead.
• Instability or looseness: A feeling that the shoulder is going to pop out of place or a sensation of looseness in the joint.
• Dislocation: An actual dislocation, where the humeral head comes completely out of the glenoid cavity.
• Subluxation: A partial dislocation, where the humeral head partially comes out of the glenoid cavity.
• Popping or clicking: A sound or sensation of the shoulder popping or clicking out of place.
• Weakness: Decreased strength in the affected arm, which can make it difficult to perform activities that require overhead movement.
• Decreased range of motion: Reduced ability to move the affected arm in certain directions, such as overhead.

These are some of the signs and symptoms that may be associated with anterior shoulder instability. If you are experiencing these symptoms, it’s important to seek the evaluation and care of a healthcare professional to determine the cause and develop an appropriate treatment plan.

Treatment for Anterior Shoulder Instability

Physiotherapy can play an important role in the treatment and management of anterior shoulder instability.

The following are some of the physiotherapy interventions that may be used to treat anterior shoulder instability:

Stabilization exercises: These exercises help to improve shoulder strength and stability and reduce the risk of dislocations.

Range of motion exercises: Gentle range of motion exercises can help to improve joint mobility and prevent stiffness.

Manual therapy: This may include techniques such as soft tissue mobilization, joint mobilization, and deep tissue massage. These techniques can help to reduce pain and improve mobility.

Taping or bracing: A physiotherapist may recommend the use of taping or bracing to provide additional stability to the shoulder and reduce the risk of dislocations.

Scapular stability exercises: These exercises help to improve the stability and control of the scapula, which can help to reduce the risk of dislocations.

Proprioception exercises: These exercises help to improve the body’s awareness of its position in space, which can help to improve stability and reduce the risk of dislocations.

It is important to note that the appropriate physiotherapy intervention will depend on the severity of the instability and the individual’s specific needs and goals. A physiotherapist can design a personalized treatment plan based on a thorough assessment of the individual’s condition and goals.

If you have any questions or would like to speak to a therapist about anterior shoulder instability please call us at 03 9836 1126.

Reference:

Lane, J. G., Hurd, W. J., & Saint-Maurice, P. G. (2018). Physical therapy for patients with anterior shoulder instability: a systematic review. Physical Therapy