Expert Guide to Shoulder Instability
The shoulder, known for its wide range of motion, is the most mobile joint in the human body. This mobility, however, makes it vulnerable to instability, especially after injuries. Chronic shoulder instability arises when the upper arm bone frequently slips out of the shoulder socket, often following previous dislocations.
Understanding Shoulder Anatomy
The shoulder comprises three main bones:
- Humerus: The upper arm bone
- Scapula: The shoulder blade
- Clavicle: The collarbone
The head of the humerus fits into the glenoid, a shallow socket in the scapula. Ligaments, tendons, and muscles surround this joint, maintaining its stability and ensuring smooth movement.
What Causes Shoulder Instability?
Shoulder instability occurs when the humerus partially or completely dislocates from the glenoid socket. This can happen due to various reasons:
- Traumatic Injury: Severe trauma or injury, like a fall, can cause the shoulder to dislocate. This may damage the ligaments and cartilage (labrum), leading to conditions such as a Bankart lesion.
- Hyperlaxity: Some individuals have naturally looser ligaments, leading to instability without previous dislocations. Repetitive overhead motions in sports like swimming, tennis, and volleyball can exacerbate this condition.
- Multidirectional Instability: In rare cases, the shoulder may dislocate in multiple directions (front, back, or bottom) without prior injury, often due to inherently loose ligaments.
Recognising Symptoms of Shoulder Instability
Symptoms of chronic shoulder instability include:
- Frequent shoulder dislocations
- Sensation of the shoulder feeling loose or slipping out of place
- Pain during activities involving shoulder movement
Diagnosis and Treatment
A detailed medical history and physical examination are essential for diagnosing shoulder instability. Tests and imaging techniques, such as X-rays and MRI scans, help confirm the diagnosis and assess the extent of damage.
Non-Surgical Treatment Options
Initial treatment for chronic shoulder instability typically involves non-surgical methods:
- Activity Modification: Avoiding activities that cause discomfort or aggravate symptoms
- NSAIDs: Medications like ibuprofen and naproxen to reduce pain and inflammation
- Physical Therapy: Exercises to strengthen shoulder muscles and improve stability
Surgical Interventions
If non-surgical treatments fail, surgery may be necessary to repair damaged ligaments and restore shoulder stability. Surgical options include:
- Arthroscopy: A minimally invasive procedure using small instruments and a camera to repair shoulder tissues
- Open Surgery: In cases requiring more extensive repair, an open surgical procedure may be performed
Post-Surgery Rehabilitation
After surgery, the shoulder may be immobilised with a sling, followed by a structured rehabilitation programme to restore motion and strengthen the shoulder. Adhering to the rehabilitation plan is crucial for a successful recovery and return to daily activities.
Conclusion
Chronic shoulder instability can significantly impact daily life, but with appropriate treatment, including physical therapy and, if necessary, surgery, individuals can regain shoulder stability and function. Consulting with a healthcare professional is essential for an accurate diagnosis and effective treatment plan.
