Skip to main content

Shoulder Instability

  • Chapter
  • First Online:
The Shoulder Made Easy

Abstract

This chapter discusses the principles in diagnosing, describing, classifying, investigating and managing instability around the shoulder, with emphasis on the need to differentiate between instability and laxity.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Jaggi A, Noorani A, Malone A, Cowan J, Lambert S, Bayley I. Muscle activation patterns in patients with recurrent shoulder instability. Int J Shoulder Surg. 2012;6(4):101–7.

    Article  Google Scholar 

  2. Barden JM, Balyk R, Raso VJ, Moreau M, Bagnall K. Atypical shoulder muscle activation in multidirectional instability. Clin Neurophysiol. 2005;116(8):1846–57.

    Article  CAS  Google Scholar 

  3. Gilman S. Joint position sense and vibration sense: anatomical organisation and assessment. J Neurol Neurosurg Psychiatry. 2002;73(5):473–7.

    Article  CAS  Google Scholar 

  4. Lephart SM, Warner JJ, Borsa PA, Fu FH. Proprioception of the shoulder joint in healthy, unstable, and surgically repaired shoulders. J Shoulder Elb Surg. 1994;3(6):371–80.

    Article  CAS  Google Scholar 

  5. Saccomanno MF, Fodale M, Capasso L, Cazzato G, Milano G. Generalized joint laxity and multidirectional instability of the shoulder. Patient Saf Surg. 2015;9:15. https://doi.org/10.1186/s13037-015-0062-9.

    Article  Google Scholar 

  6. Sewell MD, Al-Hadithy N, Le Leu A, Lambert SM. Instability of the sternoclavicular joint: current concepts in classification, treatment and outcomes. Bone Joint J. 2013;95-B(6):721–31.

    Article  CAS  Google Scholar 

  7. Lee HJ, Kim NR, Moon SG, Ko SM, Park JY. Multidirectional instability of the shoulder: rotator interval dimension and capsular laxity evaluation using MR arthrography. Skelet Radiol. 2013;42(2):231–8.

    Article  Google Scholar 

  8. Huxel Bliven KC, Anderson BE. Core stability training for injury prevention. Sports Health. 2013;5(6):514–22.

    Article  Google Scholar 

  9. Willson JD, Dougherty CP, Ireland ML, Davis IM. Core stability and its relationship to lower extremity function and injury. J Am Acad Orthop Surg. 2005;13(5):316–25.

    Article  Google Scholar 

  10. Kibler WB, Press J, Sciascia A. The role of core stability in athletic function. Sports Med. 2006;36(3):189–98.

    Article  Google Scholar 

  11. Charalambous CP. Clinical examination of the shoulder. In: Charalambous CP, editor. The shoulder made easy. Springer; 2019. pp. 77–122.

    Google Scholar 

  12. Levine WN, Sonnenfeld JJ, Shiu B. Shoulder instability: common problems and solutions. Clin Sports Med. 2018;37(2):161–77.

    Article  Google Scholar 

  13. Valencia Mora M, Ibán MÁR, Heredia JD, Gutiérrez-Gómez JC, Diaz RR, Aramberri M, Cobiella C. Physical exam and evaluation of the unstable shoulder. Open Orthop J. 2017;11:946–56.

    Article  Google Scholar 

  14. Jaggi A, Lambert S. Rehabilitation for shoulder instability. Br J Sports Med. 2010;44(5):333–40.

    Article  CAS  Google Scholar 

  15. Warby SA, Ford JJ, Hahne AJ, Watson L, Balster S, Lenssen R, Pizzari T. Comparison of 2 exercise rehabilitation programs for multidirectional instability of the glenohumeral joint: a randomized controlled trial. Am J Sports Med. 2018;46(1):87–97.

    Article  Google Scholar 

  16. Watson L, Balster S, Warby SA, Sadi J, Hoy G, Pizzari T. A comprehensive rehabilitation program for posterior instability of the shoulder. J Hand Ther. 2017;30(2):182–92.

    Article  Google Scholar 

  17. Burkhead WZJ, Rockwood CAJ. Treatment of instability of the shoulder with an exercise program. J Bone Joint Surg Am. 1992;74(6):890–6.

    Article  Google Scholar 

  18. Buss DD, Lynch GP, Meyer CP, Huber SM, Freehill MQ. Nonoperative management for in-season athletes with anterior shoulder instability. Am J Sports Med. 2004;32(6):1430–3.

    Article  Google Scholar 

  19. Randelli P, Cucchi D, Butt U. History of shoulder instability surgery. Knee Surg Sports Traumatol Arthrosc. 2016;24(2):305–29.

    Article  Google Scholar 

  20. Bankart AS. Recurrent or habitual dislocation of the shoulder-joint. Br Med J. 1923;2(3285):1132–3.

    Article  CAS  Google Scholar 

  21. Patel RM, Amin NH, Lynch TS, Miniaci A. Management of bone loss in glenohumeral instability. Orthop Clin North Am. 2014;45(4):523–39.

    Article  Google Scholar 

  22. Johnson SM, Robinson CM. Shoulder instability in patients with joint hyperlaxity. J Bone Joint Surg Am. 2010;92(6):1545–57.

    Article  Google Scholar 

  23. Neer CS 2nd, Foster CR. Inferior capsular shift for involuntary inferior and multidirectional instability of the shoulder. A preliminary report. J Bone Joint Surg Am. 1980;62(6):897–908.

    Article  Google Scholar 

  24. Stucken C, Cohen SB. Management of acromioclavicular joint injuries. Orthop Clin North Am. 2015;46(1):57–66.

    Article  Google Scholar 

  25. Groh GI, Wirth MA. Management of traumatic sternoclavicular joint injuries. J Am Acad Orthop Surg. 2011;19(1):1–7.

    Article  Google Scholar 

  26. Thangarajah T, Lambert SM. Management of recurrent shoulder instability in patients with epilepsy. J Shoulder Elb Surg. 2016;25(8):1376–84.

    Article  Google Scholar 

  27. Goudie EB, Murray IR, Robinson CM. Instability of the shoulder following seizures. J Bone Joint Surg (Br). 2012;94(6):721–8.

    Article  CAS  Google Scholar 

  28. Bühler M, Gerber C. Shoulder instability related to epileptic seizures. J Shoulder Elb Surg. 2002;11(4):339–44.

    Article  Google Scholar 

  29. Robinson CM, Howes J, Murdoch H, Will E, Graham C. Functional outcome and risk of recurrent instability after primary traumatic anterior shoulder dislocation in young patients. J Bone Joint Surg Am. 2006;88(11):2326–36.

    Article  Google Scholar 

  30. Robinson CM, Seah M, Akhtar MA. The epidemiology, risk of recurrence, and functional outcome after an acute traumatic posterior dislocation of the shoulder. J Bone Joint Surg Am. 2011;93(17):1605–13.

    Article  Google Scholar 

  31. Wasserstein DN, Sheth U, Colbenson K, Henry PD, Chahal J, Dwyer T, Kuhn JE. The true recurrence rate and factors predicting recurrent instability after nonsurgical management of traumatic primary anterior shoulder dislocation: a systematic review. Arthroscopy. 2016;32(12):2616–25.

    Article  Google Scholar 

  32. Emery RJ, Mullaji AB. Glenohumeral joint instability in normal adolescents. Incidence and significance. J Bone Joint Surg (Br). 1991;73(3):406–8.

    Article  CAS  Google Scholar 

  33. McFarland EG, Campbell G, McDowell J. Posterior shoulder laxity in asymptomatic athletes. Am J Sports Med. 1996;24(4):468–71.

    Article  CAS  Google Scholar 

  34. Jia X, Ji JH, Petersen SA, Freehill MT, McFarland EG. An analysis of shoulder laxity in patients undergoing shoulder surgery. J Bone Joint Surg Am. 2009;91(9):2144–50.

    Article  Google Scholar 

  35. Hakim A, Grahame R. Joint hypermobility. Best Pract Res Clin Rheumatol. 2003;17(6):989–1004.

    Article  Google Scholar 

  36. Jessee EF, Owen DS Jr, Sagar KB. The benign hypermobile joint syndrome. Arthritis Rheum. 1980;23(9):1053–6.

    Article  CAS  Google Scholar 

  37. Laudner K, Meister K, Noel B, Deter T. Anterior glenohumeral laxity is associated with posterior shoulder tightness among professional baseball pitchers. Am J Sports Med. 2012;40(5):1133–7.

    Article  Google Scholar 

  38. Bigliani LU, Codd TP, Connor PM, Levine WN, Littlefield MA, Hershon SJ. Shoulder motion and laxity in the professional baseball player. Am J Sports Med. 1997;25(5):609–13.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Panayiotou Charalambous, C. (2019). Shoulder Instability. In: The Shoulder Made Easy . Springer, Cham. https://doi.org/10.1007/978-3-319-98908-2_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-98908-2_14

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-98907-5

  • Online ISBN: 978-3-319-98908-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics