Diagnoses and symptoms

Shoulder instability

There are many causes for shoulder instability. Physiotherapy and orthoses are important elements of therapy success.

Summary

Causes, symptoms and treatment

The shoulder joint is one of three synovial joints in the shoulder girdle. It is a highly mobile joint controlled by muscles. Various factors can lead to instability in the shoulder region.

Ottobock supports and orthoses

A mother holds one child while holding hands with another as they stroll outside through a field. The mother is wearing the Ottobock's C-Brace.

Causes

Shoulder instability can have various causes. In some cases, overstretched capsular ligament structures or disturbances in muscle function trigger the unstable situation in the shoulder joint. Other cases have traumatic or postoperative causes.
Shoulder instability frequently relates to the upper arm-shoulder blade joint (glenohumeral joint). In severe cases, however, the entire shoulder girdle with all three synovial and two cartilaginous joints may be affected.
An instability can lead to a dislocation. In this case, the joint head of the upper arm no longer sits in its normal position in the joint socket formed by the shoulder blade (scapula).

Symptoms

One of the main symptoms of an acute shoulder dislocation caused, for example, by excessive laxity of the capsular ligament structures, is limited mobility in the shoulder joint along with pain. This is accompanied by sudden pain and pain during movement as well as an altered shoulder shape with an indentation on the acromion (the bony process on the scapula). Vessels and nerves in the area of the armpit are often damaged, which can lead to circulatory disorders and therefore to unpleasant sensations in the arm.

Diagnosis

Shoulder instability is diagnosed by an orthopaedist after taking a detailed medical history and assessing the findings. Imaging procedures such as X-rays, computer tomography (CT) and magnetic resonance imaging (MRI) provide further information about the exact state of the shoulder. Accompanying muscle injuries can be diagnosed or ruled out at the same time.

Therapy

While the therapy for shoulder instability is highly individual, a conservative approach is usually taken in the form of physiotherapy. A particular focus is stabilising the muscles in the entire shoulder region. Orthoses are commonly used so that healing is not delayed by uncontrolled movements.
In cases where the patient no longer has just ligamentous laxity but subsequent injuries as well, surgery is often necessary followed by rehabilitation and immobilisation of the operating site for three to 12 weeks. The goal is to restore the original state with the help of appropriate physiotherapy, lymphatic drainage and movement therapy. Orthoses can also stabilise the joint and prevent unnecessary pain in this situation.