Our shoulder is one of the most mobile joints in our body. As a ball-and-socket joint, it allows multidirectional movements enabling us to reach, lift and rotate in different angles to perform daily activities. Greater mobility unfortunately results in reduced stability, our shoulder is the most dislocated joint in the body where it represents 50% of all major joint dislocations. After the first shoulder dislocation, the likelihood of re-dislocation is over 90% particularly among adolescents. To ensure safe movements, our rotator cuff muscles, shoulder capsular ligaments and bones (collarbone, shoulder blades and upper arm) have important roles in providing strength and stability to the shoulder complex.
How does shoulder instability occur?
Instability occurs when the head of the upper arm bone is forced out of the shoulder socket. When the joint is forced completely out of the socket, dislocation happens. If the joint slides partially out of the socket, subluxation occurs. Causes of shoulder instability includes,
Injuries that cause ligaments at the shoulder joint to be stretched and torn may result in instability. It is likely to be happened after a fall with an outstretched arm, shoulder injuries at the gym or sport-related injuries. Repetitive trauma will result in higher risk of instability if the shoulder is not trained properly.
2. Repetitive strain
Repeated overhead movements can overstretch the shoulder ligaments causing them to be loose. Looser ligaments can make it hard to maintain shoulder stability. Sports player such as tennis, swimming etc. and manual laborer who performs repetitive overhead movements are more likely to develop instability.
3. General instability
The shoulder joint can be unstable without a history of injury or repetitive strain. People who have naturally loose ligaments such as joint hypermobility syndrome are prone to instability. Due to increased tissue laxity, the shoulder may feel loose in multi-directions leading to a high risk of injury.
What symptoms should I look out for?
Common symptoms of shoulder instability include:
- Pain caused by shoulder injury
- Repeated shoulder dislocations
- Repeated instances of the shoulder giving out
- A persistent sensation of the shoulder feeling loose, slipping in and out of the joint, or just “hanging there”
How can physiotherapy help?
Whether or not you sustained an injury, strained your shoulder, or being hypermobile. There are ways to improve your shoulder stability. Thorough postural and movement assessment by your experience physiotherapist can identity the root problem. Through targeted training, risk of chronic instability and re-injuries can be greatly reduced. Your physiotherapist will provide hands-on treatment, targeted strengthening to rotator cuff and scapular muscles, proprioception exercise, sports-specific training and clinical pilates to help you achieve your goals.
To make an appointment, call our Claremont physio clinic on (08) 9384 1555 or our Nedlands physio clinic on (08) 6389 2947.