Patient Education
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Chronic Shoulder Instability is a condition where the head or top of the arm bone (humerus) repeatedly slips out of the shoulder socket (glenoid).
Common Symptoms
- Pain caused by shoulder injury
- Repeated shoulder dislocations or subluxations (partial dislocations)
- Persistent sensation of the shoulder feeling loose or slipping in and out of the joint
- Shoulder weakness, especially during activity
- Decreased range of motion
Cause & Anatomy
Causes of Chronic Shoulder Instability:
- Severe trauma or injury causing an initial shoulder dislocation that damages the ligaments and capsule
- Repetitive overhead motions like throwing that loosen the shoulder capsule over time
- Genetic condition of loose ligaments (hyperlaxity) leading to instability without injury
Anatomy of Chronic Shoulder Instability:
- Humerus (upper arm bone)
- Glenoid (shallow socket in the shoulder blade)
- Shoulder capsule and ligaments that keep the humerus centered in the glenoid
- Rotator cuff and other shoulder muscles that dynamically stabilize the joint
Diagnosis
- Physical exam to check for looseness, weakness, range of motion
- Imaging tests like MRI or CT scan, sometimes with contrast dye injection (arthrogram)
- Examination under anesthesia followed by arthroscopy
Prevention
Strengthening shoulder muscles and improving motor control through physical therapy can help prevent instability, especially after an initial dislocation.
Non-Surgical Treatment
- Activity modification, anti-inflammatory medication
- Physical therapy to strengthen muscles and improve control
Surgery
Surgical (if nonsurgical treatment fails):
- Arthroscopic or open repair of torn ligaments and capsule to stabilize the joint
Post Surgical Rehabilitation
- Immobilization with a sling for several weeks
- Physical therapy to regain range of motion and prevent scarring
- Gradually progressing to strengthening exercises as healing allows
- Commitment to rehab is crucial for a successful outcome
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