My shoulder feels like it's coming out of place! Shoulder instability explained and tips for management.
Oshin Amberkar August 24
After the epic gold win in gymnastics and swimming at Olympics, I am sure everyone will be pumped to get back at sports. Summer sports and pre-season training are in full swing, leading to an uptick in injuries and accidents. One frequently observed injury is shoulder joint dislocation or subluxation, often caused by traumatic events like falls, hard landings, and tackles. A direct impact to the shoulder, forceful throwing, lifting, or contact with other players can sometimes move the joint out of its usual place.
In simple terms, shoulder instability may be described as the feeling that your shoulder is “giving way”, moving out of place, or feeling unstable.
Types and Causes of Shoulder Instability
Shoulder instability occurs when some of the structures around the shoulder joint that usually keep it in place securely get a bit too loose and allow the joint to move around too much in the socket. It can be classified into three main types:
Traumatic Instability: Often resulting from an acute injury, such as a fall, tackle or a sports-related incident. This can lead to a dislocation or subluxation (partial dislocation) of the shoulder joint.
Atraumatic Instability: Generally caused by repetitive overhead activities like swimming or gymnasts or seen in people that just have loose joints – you know those people who can bend their thumbs right back!
Micro-traumatic Instability: Arises from repetitive microtrauma over time, commonly seen in athletes involved in overhead sports like tennis.
How do I know if I have Shoulder instability?
Feeling your shoulder is fully or partially going out of place or if your shoulder feels loose and weak, are all tell-tale signs of instability. You might also feel that you are losing some range and getting stiff around the shoulder. Sometimes you might get a feeling of numbness in the shoulder.
If you suspect you have shoulder instability or are experiencing any of the above symptoms, it’s best to seek evaluation by your physiotherapist or doctor. They will discuss your symptoms, physically examine your shoulder, and possibly order X-rays or an MRI to get further information on your condition.
What are the treatment options?
Treatment depends on the severity of your condition. Some patients may need surgical intervention if their shoulder keeps dislocating while some can recover by initially resting and avoiding activities that might cause additional shoulder stress and then focusing hard on strengthening.
Role of Physiotherapy
Physiotherapy is crucial in managing shoulder instability, especially for non-surgical cases and those who are post-surgery. The main goals are to restore shoulder stability, strength, and function. Key components of physiotherapy include:
Strengthening Exercises: These focus on strength and endurance of the rotator cuff (the small but very important muscles around the shoulder joint) and the shoulder blade muscles (also very important in shoulder function). We might start with bands and then move into weights and then gym work as the shoulder gets stronger.
Neuromuscular Training: This type of rehab focuses on coordination and control of shoulder movements to prevent future dislocations or subluxations, so the smaller muscles interact with the bigger muscles.
Functional Training: This type of training is specific to each patient as each patient has different goals, sports, daily activities and things they want to achieve so this type of rehab mimics daily activities and sports-specific movements to ensure the shoulder can handle real-life demands
Take Away Rehab Tips Based on the Latest Research
Recent studies emphasize the importance of a structured and progressive rehabilitation program. Here are some research-backed tips:
Early Mobilization: Gradual and controlled movement of the shoulder joint early in the rehab process can prevent stiffness and promote healing. However, it should be done under the guidance of a physiotherapist to avoid re-injury.
Shoulder blade Control: Exercises that enhance shoulder blade stability are vital. This includes exercises like scapular retractions, serratus punches, and prone Y’s and T’s
Progressive Load Bearing: Gradually increasing the load through resistance exercises helps in building strength and endurance. This progression is crucial for long-term stability and function.
Core Stability: Since shoulder movement is closely linked with core stability, integrating core strengthening exercises into the rehab program can significantly improve outcomes.
Summary
Shoulder instability cases can be managed effectively with a well-structured physiotherapy program whether you need surgery or not. Understanding the type and cause of instability is the first step towards effective treatment. Physiotherapy focuses on strengthening, neuromuscular training, and functional exercises to restore stability and prevent future issues. Following evidence-based rehab tips ensures a safe and efficient recovery process, helping patients return to their normal activities and sports with confidence.
What to Do Next…
At Rehab Rooms, we are here to get you back on track to what you want to do. We believe that successful treatment is down to accurate diagnosis and assessment, leading to effective treatment outcomes. Why not book online on our website or call us at 01 430 5634 to schedule a time that works for you?