Shoulder
Shoulder instability
by Uperform
Shoulder instability is a pathology that usually occurs as a result of shoulder dislocation or recurrent (sub)luxations. This corresponds to the loss of contact between the head of the humerus and the glenoid.
1) A LITTLE ANATOMY:
The shoulder joint is made up of 3 bones: the clavicle, the scapula (or scapula) and the humerus.
Its mobility and stability are ensured by a musculotendinous and ligament complex.
2) WHAT IS SHOULDER INSTABILITY? WHAT IS THE DIFFERENCE WITH A DISLOCATED SHOULDER? WHAT ARE THE LESION MECHANISMS?
Shoulder instability is a pathology that usually occurs as a result of shoulder dislocation or recurrent (sub)luxations. This corresponds to the loss of contact between the head of the humerus and the glenoid.
This type of incident creates a distension or even rupture of some of these ligaments, causing fragility and chronic instability of the shoulder.
The situation can quickly escalate into a vicious circle:
The more the number of episodes of (sub)luxation increases, the more the joint will be unstable and the structures damaged.
The more the shoulder is unstable, the more it will risk dislocating, sometimes in innocuous gestures
It should be noted that the more the subject undergoes a first event of young dislocation, the more the risk of recurrence will be important.
The mechanisms of injury can be diverse. However, they are generally linked to a first trauma.
Ligament instability/laxity
Sudden arm swing
Violent direct shock
In other cases, it is repeated microtraumas that can create instability, without any real dislocating event.
This pathology mainly affects young and active patients, especially women (higher laxity). The first events of dislocation most often occur during the practice of a sport.
3) WHAT ARE THE SYMPTOMS?
General complaints encountered by subjects with shoulder instability are:
Sharp and embarrassing pains in everyday life
Sensation of instability, flight
Joint stiffness
Joint blockage
Crunches
As mentioned earlier, recurrent (sub)luxation events are also a clear sign of shoulder instability.
4) IS IT SERIOUS?
Shoulder instability is a relatively common problem in young athletes, especially in sports involving arm movement (handball, volleyball, tennis, etc.). The earlier the diagnosis, the better the prognosis.
The intensity of the pain as well as the level of loss of functionality of the knee are however specific to each situation.
5) IS SURGERY MANDATORY?
Surgery will only concern a small proportion of pathologies of this type and should in no case represent a first-line treatment.
It will be reserved for patients whose physio and medical treatments have failed.
Its purpose will be to stabilize the shoulder in order to prevent repeated dislocations and allow the resumption of activities while preventing possible complications that could arise following the progressive deterioration of the joint.
6) HOW DOES REHABILITATION TAKE PLACE?
The physiotherapy treatment will focus on:
Educating the patient about his pathology and the information to remember in order to avoid recurrences/complications
Obtaining normalized ranges of motion
Gradual rehabilitation of the joint
Global and specific muscle strengthening of the shoulder and back (strength, neuromuscular control, stability, etc.)
Re-athletics and getting back into sport (with technical correction if necessary)
7) WILL I RETURN TO MY PRE-INJURY LEVEL?
If this type of pathology needs to be monitored, it will not prevent you from returning to your optimal level of performance.
However, be careful not to let the episodes follow one another, at the risk of reducing the favorable prognosis for recovery.
8) CAN I CONTINUE TO TRAIN?
In the event of a subluxation episode, it is usually important to stop sporting activity so as not to aggravate the lesion.
Consulting a health professional then makes it possible to determine the procedure to follow in order to return to your sports practice as quickly as possible in complete safety.
9) WHAT CAN I DO TO SPEED UP THE PROCESS?
In order to speed up the healing process, be sure to follow the recommendations of the health professionals with whom you work.
Laziness or, on the contrary, overzealousness, will be your enemies.
Conversely, discipline, rigor, perseverance as well as a positive and voluntary state of mind will help you get back in top shape as soon as possible!