Definition

Glenohumeral instability means the shoulder is often easily displaced or even fully dislocated.  Shoulder dislocation refers to the humerus bone moves out of the normal position. It is commonly dislocated forward or downward which squeezes and pulls the surrounding tissue causing injury and pain. If fully dislocated, the joint will temporarily lose mobility. The younger the first full dislocation of the shoulder, the higher the chance of recurrence afterward. If the labrum is torn, the shoulder stability will be affected, which results in a higher chance of recurrent dislocation.
Self File | 肩關節脫位 Glenohumeral instability_肩痛成因物理治療2

 

 

Causes



Shoulder dislocation usually occurs in shoulder abduction, external rotation, and extension. Sometimes fall on the hand or elbow will cause the humeral head to displace and result in dislocation. There are many reasons for chronic glenohumeral instability, one of which is insufficient rehabilitation. The cause of pain in young patients is mainly a labral tear or a biceps tear when dislocated. The pain of older patients is often caused by torn rotator cuff muscles.

Self File | Glenohumeral instability 肩關節脫位_Shoulder Pain Causes, Physiotherapy Treatment

 

 

Risk Factors
  • People with congenital joint instability: such as Marfan Syndrome
  • Participate in contact sports: It is unavoidable that there will be collisions with others during exercise.
  • Fall on hands and elbow may cause dislocation.
  • The action of overhead ball-throwing, like football, basketball, baseball, tennis, and handball (highest risk),   may cause joint instability.

 

 

Common Symptoms
  • Feeling your shoulders dislocated, getting stuck, or even unable to move
  • Patients may repeatedly experience shoulder joint subluxation or even dislocation at a certain position, such as basketball shooting, volleyball smash, backstroke strokes, etc. Some may even feel unstable or subluxation when holding handlebars on a bus encountering an emergency brake.
  • Paralysis of upper limbs
  • Shoulder appearance may change

 

 

Management

Under the guidance of a physiotherapist, a gradual and comprehensive rehabilitation to train up the shoulder muscle strength and proprioception to improve the stability of the shoulder joint is important.

However, sometimes the torn shoulder joint tissue caused by injury is not easy to heal by itself. It may be necessary to receive surgical repair of the torn ligament and tighten the loose joint capsule.

 

After the operation, a shoulder sling is used to protect for 2 to 4 weeks with gradual onset of passive joint mobilization, Muscle training begins only after 8 to 9 weeks after the operation, and daily activities can be resumed after 12 weeks. Patients can usually return to contact sports safely at 4 to 6 months post-operation with proper rehabilitation.

Self File | 肩關節脫位 Glenohumeral instability_肩痛成因物理治療運動

 

 

Preventive Measures

It is not easy to prevent dislocation of the shoulder joint because it is an instinctive reaction of the body to support the ground when falling. But the following are some effective methods:

  • Warm-up and exercise more to strengthen shoulder muscles and stabilize shoulder joints
  • Wear appropriate protective equipment when participating in sports
  • Pay attention to safety and avoid falling as much as possible

 

 

 

 

 

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