Shoulder Instability

Shoulder instability is a condition where the shoulder joint is not stable and may feel like it is going to dislocate or move out of place. There are two types of shoulder instability:

Traumatic shoulder instability: This occurs after a significant injury, such as a fall or a blow to the shoulder, which causes the ligaments or capsule surrounding the shoulder joint to become stretched or torn.

Atraumatic shoulder instability: This occurs when the shoulder is unstable without a specific traumatic event, and can be caused by repetitive overhead activities, hypermobility, or congenital conditions.

Symptoms of shoulder instability include a feeling of the shoulder slipping out of place, pain or discomfort when moving the arm, weakness in the shoulder, and a popping or clicking sound. Treatment options for shoulder instability include physical therapy, anti-inflammatory medication, and in some cases, surgery may be required to repair or reconstruct the damaged ligaments or capsule. It is important to seek medical attention if you experience any symptoms of shoulder instability, as the condition can worsen over time and lead to more severe injuries.

Causes of Shoulder Instability

Shoulder instability can be caused by a variety of factors, including:

Traumatic injury: A traumatic injury, such as a fall, can cause the shoulder joint to dislocate or cause damage to the ligaments or capsule surrounding the joint.

Repetitive overhead activities: Activities that require repetitive overhead motions, such as throwing a ball or swimming, can lead to shoulder instability over time due to the repetitive stress on the joint.

Hypermobility: Some people are born with more flexible ligaments and joints, which can increase the risk of shoulder instability.

Muscle weakness or imbalances: Weakness in the muscles that support the shoulder, or muscle imbalances that cause some muscles to be stronger than others, can increase the risk of shoulder instability.

Congenital conditions: Certain conditions that affect the development of the shoulder joint, such as Ehlers-Danlos syndrome or Marfan syndrome, can increase the risk of shoulder instability.

It is important to identify the underlying cause of shoulder instability in order to determine the most effective treatment approach. Your healthcare provider can help determine the cause of your shoulder instability and develop a treatment plan that is tailored to your individual needs.

Signs and Symptoms of Shoulder Instability

The signs and symptoms of shoulder instability can vary depending on the cause and severity of the condition. Some common signs and symptoms include:

• A sensation that the shoulder is loose or may dislocate: This is often described as feeling like the shoulder is slipping out of place or that it may dislocate with certain movements.
• Pain or discomfort: You may experience pain or discomfort in the shoulder joint, particularly during activities that involve overhead motions.
• Weakness: The shoulder may feel weak or unstable, making it difficult to perform certain activities or movements.
• Popping or clicking sounds: You may hear a popping or clicking sound when moving the shoulder, particularly when raising your arm.
• Limited range of motion: Shoulder instability can cause a limited range of motion, making it difficult to move the arm in certain directions.
• Swelling or bruising: In cases of traumatic shoulder instability, swelling or bruising may be present around the shoulder joint.

It is important to seek medical attention if you experience any of these symptoms, as shoulder instability can worsen over time and lead to more severe injuries. Your healthcare provider can perform a physical exam and imaging tests to determine the underlying cause of your shoulder instability and develop an appropriate treatment plan.

Treatment of Shoulder Instability

Physiotherapy is an important part of the treatment plan for shoulder instability. A physiotherapist can design a program to help you manage your symptoms, improve shoulder stability, and prevent future injuries. Some common physiotherapy treatments for shoulder instability include:

Strengthening exercises: Strengthening the muscles around the shoulder joint, such as the rotator cuff and scapular stabilizers, can help improve shoulder stability and prevent future instability.

Range of motion exercises: Gentle exercises to improve the range of motion in the shoulder can help reduce pain and improve function.

Proprioceptive training: Proprioception refers to your body’s awareness of its position in space. Proprioceptive training involves exercises to improve your shoulder’s proprioception, which can help improve stability and reduce the risk of future injuries.

Manual therapy: Manual therapy techniques, such as joint mobilization or soft tissue massage, can help reduce pain and improve mobility in the shoulder joint.

Taping or bracing: Taping or bracing the shoulder can help provide additional support and stability to the joint, which can help reduce symptoms and prevent further injury.

Your physiotherapist will work with you to develop a customized treatment plan based on your individual needs and goals. It is important to follow your physiotherapy program as directed and to communicate any changes in your symptoms to your healthcare provider.

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

Reference:

Hegedus, E. J., Goode, A., Campbell, S., Morin, A., Tamaddoni, M., Moorman, C. T., & Cook, C. (2016). Physical examination tests of the shoulder: a systematic review with meta-analysis of individual tests. British Journal of Sports Medicine, 50(5), 281-287.