Shoulder Anterior Instability - Fact Sheet

What is it?

Shoulder instability can occur following traumatic injury (such as a shoulder dislocation or subluxation), or if a person is naturally hypermobile through the shoulder joint. If the ligaments, tendons, labrum and capsule of the shoulder are generally looser (lax), the shoulder joint moves in a more uncontrolled manner. This laxity can lead to other issues, such as rotator cuff impingement, labrum tears, or further risk of dislocation.

AC joint injury

Signs and symptoms of Shoulder Anterior Instability?

• History of dislocation or subluxation – every dislocation or subluxation further stretches the ligaments and capsule of the shoulder, leading to further joint laxity.
• Positive instability on clinical testing/assessment
• Apprehension – the feeling that the shoulder will dislocate and the bodies subsequent involuntary muscle contractions to keep the shoulder in place
• Positive shoulder impingement/pain, secondary to shoulder instability
• Untreated instability can result in increased load on the ligaments and muscles of the shoulder, leading to other injuries secondary to the instability.


Treatment for Shoulder Anterior Instability?

Acute injury management: if you are recovering from a subluxation or dislocation, it is important to give the shoulder some rest to allow it to settle down.

Activity modification: Avoiding activities or exercises that put the shoulder at risk of causing further injury, UNTIL there is better motor control and stability of the shoulder. Rehab will aim to progress you back to completing these activities safely.

Strengthening exercises: the KEY to rehabilitating or managing shoulder instability. Specific strengthening of the shoulder blade and rotator cuff musculature improves the stability and motor control of the shoulder joint.

Other intervention: depending on the severity of the instability, and especially in light of previous dislocation, a surgical opinion may be warranted. This is especially important if you are an athlete that uses the upper limb in their given sport.

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