Shoulder instability

The shoulder joint is one of three joints in the shoulder girdle. It is a highly moveable joint guided by muscles. Various factors can result in shoulder instability.


Causes

Shoulder instability can have various causes. In some cases, excessive stretching of the capsular ligament structures or muscle function disturbances cause the unstable situation in the shoulder joint. Traumatic or postoperative causes are responsible in other cases.

Shoulder instability frequently involves the upper arm-shoulder blade joint (glenohumeral joint). In severe cases however, the entire shoulder girdle with all three true joints and two pseudo-joints can be affected.

Instability can result in luxation. Then the upper arm joint head is no longer in its normal position in the joint socket, which is formed by the bone of the shoulder blade.

Symptoms

One of the main symptoms of acute shoulder luxation, for example due to excessive laxity of the capsular ligament structures, is a painful restriction of mobility in the shoulder joint. Pain also occurs spontaneously and when moving. The shape of the shoulder is altered with an indentation on the acromion. In many cases the vessels and nerves in armpit are damaged, which can lead to circulatory disorders and therefore unpleasant sensations in the arm.

Diagnosis

Shoulder instability is diagnosed by an orthopaedist after a detailed anamnesis and examination. Imaging procedures such as X-rays, computer tomography (CT) and magnetic resonance imaging (MRI) provide more information about the precise state of the shoulder. The accompanying injury of muscles can be established or excluded at the same time.

Therapy

The therapy for shoulder instability is highly individual, but treatment is usually conservative by means of physiotherapy. Here special attention is paid to the muscular stabilisation of the entire shoulder region. Orthoses are used regularly so that healing is not delayed due to uncontrolled movements.

When there are subsequent injuries rather than just simple ligament laxities, surgery is often required. This is followed by rehabilitation and immobilisation of the surgical area for 3 to 12 weeks. The aim is to restore the original state through targeted physiotherapy, lymph drainage and movement therapy. Once again, orthoses can stabilise the joint and prevent unnecessary pain.


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