What is shoulder instability?
Shoulder instability is a problem that occurs when the structures that surround the gleno-humeral (shoulder) joint do not work to maintain the ball within its socket. If the joint is too loose, is may slide partially out of place, a condition called shoulder subluxation.
If the joint comes completely out of place, this is called a shoulder dislocation.
Patients with shoulder instability often complain of an uncomfortable sensation that their shoulder may be about to slide out of place - this is what is called apprehension.
Hence, the name for the test that chiropractors use to identify shoulder instability – the apprehension test.
Instability or subluxation is often present as the underlying mechanism responsible for a broad spectrum of shoulder dysfunction. There need not be a history of dislocation and often instability exists without the awareness of subluxation. Therefore it is always important to assess for, especially in athletic populations such as throwers or swimmers etc.
1. Prior Shoulder Dislocations:
2. Young Athletes Athletes:
3. "Double-Jointed" Patients:
Chiropractors have many tools at their disposal to treat shoulder instability. Treatment depends on several factors and may often begin with chiropractic manipulation, mobilisation and followed by rehabilitation.
If patients complain of a feeling that their shoulder is loose or about to dislocate, chiropractic treatment with specific strengthening exercises will often help maintain the shoulder in proper position.
A strengthening regime will almost always focus on the rotator cuff musculature to build a stronger supportive network around the shoulder joint itself as well as focusing on more of the dynamic stabilisers of the shoulder, of which there are around 30.
Shoulder strengthening is most likely to help the second group of patients - athletes with multidirectional shoulder instability.
Sports taping and wearing a support are important adjunctive methods to stabilise the shoulder.
Other treatments sometimes used to treat shoulder instability include sclerosing injections and, if severe, surgery.