Skip to main content
SpringerLink
Log in

Conservative Treatment of Multidirectional Instability of the Shoulder

  • Chapter
  • First Online:
360° Around Shoulder Instability

  • 891 Accesses

Abstract

Altered activation of shoulder girdle muscles is always present in patients with joint laxity and multidirectional shoulder instability. Conservative treatment is the first-line treatment if no structural lesions are present and should be performed for at least 1 year according to a specific protocol. Kinesiotherapy is also crucial in patients who underwent treatment to maintain proper biomechanics of glenohumeral joint. Currently a protocol described by Watson and his colleagues provides best proven reliability.

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

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.99
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. Kibler WB. The role of the scapular in athletic shoulder function. Am J Sports Med. 1998;26:325–37.

    CAS  PubMed  Google Scholar 

  2. Wang VM, Flatow EL. Pathomechanics of acquired shoulder instability: a basic science perspective. J Shoulder Elbow Surg. 2005;14(1 Suppl S):2S–11S.

    PubMed  Google Scholar 

  3. Tannenbaum E, Sekiya JK. Evaluation and management of posterior shoulder instability. Sport Health. 2011;3(3):253–63.

    Google Scholar 

  4. Debski RE, Sakone M, Woo SL, Wong EK, Fu FH, Warner JJ. Contribution of the passive properties of the rotator cuff to glenohumeral stability during anterior-posterior loading. J Shoulder Elbow Surg. 1999;8(4):324–9.

    CAS  PubMed  Google Scholar 

  5. Ogston JB, Ludewig PM. Differences in 3-dimensional shoulder kinematics between persons with multidirectional instability and asymptomatic controls. Am J Sports Med. 2007;35:1361–70.

    PubMed  Google Scholar 

  6. Provencher MT, LeClere LE, King S, McDonald LS, Frank RM, Mologne TS, et al. Posterior instability of the shoulder: diagnosis and management. Am J Sports Med. 2011;39(4):874–86.

    PubMed  Google Scholar 

  7. Allegrucci M, Whitney SL, Lephart SM, Irrgang JJ, Fu FH. Shoulder kinesthesia in healthy unilateral athletes participating in upper extremity sports. J Orthop Sports Phys Ther. 1995;21(4):220–6.

    CAS  PubMed  Google Scholar 

  8. Herrington L, Horsley I, Rofl C. Evaluation of shoulder joint position sense in both asymptomatic and rehabilitated professional rugby players and matched controls. Phys Ther Sport. 2010;11(1):18–22.

    PubMed  Google Scholar 

  9. Myers JB, Lephart SM. The role of the sensorimotor system in the athletic shoulder. J Athl Train. 2000;35(3):351–63.

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Bahu MJ, Trentacosta N, Vorys GC, Covey AS, Ahmad CS. Multidirectional instability: evaluation and treatment options. Clin Sports Med. 2008;27:671–89.

    PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  12. Saccomanno MF, Fodale M, Capasso L, Cazzato G, Milano G. Generalized joint laxity and multidirectional instability of the shoulder. Joints. 2013;1(4):171–9.

    PubMed  Google Scholar 

  13. Blasier RB, Carpenter JE, Huston LJ. Shoulder proprioception. Effect of joint laxity, joint position, and direction of motion. Orthop Rev. 1994;23(1):45–50.

    CAS  PubMed  Google Scholar 

  14. Beasley L, Faryniarz DA, Hannafin JA. Multidirectional instability of the shoulder in the female athlete. Clin Sports Med. 2000;19:331–49.

    CAS  PubMed  Google Scholar 

  15. Guerrero P, Busconi B, Deangelis N, Powers G. Congenital instability of the shoulder joint: assessment and treatment options. J Orthop Sports Phys Ther. 2009;39:124–34.

    PubMed  Google Scholar 

  16. Morris AD, Kemp GJ, Frostick SP. Shoulder electromyography in multidirectional instability. J Shoulder Elbow Surg. 2004;13:24–9.

    PubMed  Google Scholar 

  17. Illyes A, Kiss RM. Kinematic and muscle activity characteristics of multidirectional shoulder joint instability during elevation. Knee Surg Sports Traumatol Arthrosc. 2006;14:673–85.

    PubMed  Google Scholar 

  18. Basmajian JV, Bazant FJ. Factors preventing downward dislocation of the adducted shoulder joint. J Bone Joint Surg. 1959;41:1182–6.

    PubMed  Google Scholar 

  19. Kuroda S, Sumiyoshi T, Moriishi J, et al. The natural course of atraumatic shoulder instability. J Shoulder Elbow Surg. 2001;10(2):100–4.

    CAS  PubMed  Google Scholar 

  20. Burkhead WZ Jr, Rockwood CA Jr. Treatment of instability of the shoulder with an exercise program. J Bone Joint Surg Am. 1992;74:890–6.

    PubMed  Google Scholar 

  21. Warby SA, Pizzari T, Ford JJ, Hahne AJ, Watson L. The effect of exercise-based management for multidirectional instability of the glenohumeral joint: a systematic review. J Shoulder Elbow Surg. 2014;23:128–42.

    PubMed  Google Scholar 

  22. Voight ML, Hardin JA, Blackburn TA, et al. The effects of muscle fatigue on and the relationship of arm dominance to shoulder proprioception. J Orthop Sports Phys Ther. 1996;23(6):348–52.

    CAS  PubMed  Google Scholar 

  23. Mallon WJ, Speer KP. Multidirectional instability: current concepts. J Shoulder Elbow Surg. 1995;4(Pt 1):54–64.

    CAS  PubMed  Google Scholar 

  24. Tillander B, Lysholm M, Norlin R. Multidirectional hyperlaxity of the shoulder: results of treatment. Scand J Med Sci Sports. 1998;8:421–5.

    CAS  PubMed  Google Scholar 

  25. Illyes A, Kiss J, Kiss RM. Electromyographic analysis during pull, forward punch, elevation and overhead throw after conservative treatment or capsular shift at patient with multidirectional shoulder joint instability. J Electromyogr Kinesiol. 2009;19:e438–47.

    PubMed  Google Scholar 

  26. Kiss RM, Illyes A, Kiss J. Physiotherapy vs. capsular shift and physiotherapy in multidirectional shoulder joint instability. J Electromyogr Kinesiol. 2010;20:489–501.

    PubMed  Google Scholar 

  27. Ide J, Maeda S, Yamaga M, Morisawa K, Takagi K. Shoulder strengthening exercise with an orthosis for multidirectional shoulder instability: quantitative evaluation of rotational shoulder strength before and after the exercise program. J Shoulder Elbow Surg. 2003;12:342–5.

    PubMed  Google Scholar 

  28. Misamore GW, Sallay PI, Didelot W. A longitudinal study of patients with multidirectional instability of the shoulder with seven- to ten-year follow-up. J Shoulder Elbow Surg. 2005;14:466–70.

    PubMed  Google Scholar 

  29. Watson L, Warby S, Balster S, Lenssen R, Pizzari T. The treatment of multidirectional instability of the shoulder with a rehabilitation program: Part 1. Shoulder Elbow. 2016;8(4):271–8.

    PubMed  PubMed Central  Google Scholar 

  30. Watson L, Warby S, Balster S, Lenssen R, Pizzari T. The treatment of multidirectional instability of the shoulder with a rehabilitation programme: part 2. Shoulder Elbow. 2016;9(1):46–53.

    PubMed  PubMed Central  Google Scholar 

  31. 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.

    PubMed  Google Scholar 

  32. Kiss J, Damrel D, Mackie A, Neumann L, Wallace WA. Non-operative treatment of multidirectional shoulder instability. Int Orthop. 2001;24:354–7.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Shoulder and Upper Limb Department, St. Luke’s Hospital, Biełsko-Biala, Poland

    Wojciech Solecki, Patryk Kłaptocz, Adrian Blasiak & Roman Brzóska

Authors
  1. Wojciech Solecki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Patryk Kłaptocz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Adrian Blasiak
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Roman Brzóska
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wojciech Solecki .

Editor information

Editors and Affiliations

  1. Shoulder and Upper Limb Department, St. Luke's Hospital, Bielsko-Biała, Poland

    Roman Brzóska

  2. Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy

    Giuseppe Milano

  3. Istituto Ortopedico Gaetano Pini, Prima Clinica Ortopedica, Milan, Italy

    Pietro S. Randelli

  4. Department of Traumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia

    Ladislav Kovačič

Rights and permissions

Reprints and permissions

Copyright information

© 2020 ESSKA

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Solecki, W., Kłaptocz, P., Blasiak, A., Brzóska, R. (2020). Conservative Treatment of Multidirectional Instability of the Shoulder. In: Brzóska, R., Milano, G., Randelli, P., Kovačič, L. (eds) 360° Around Shoulder Instability. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-61074-9_40

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-61074-9_40

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-61073-2

  • Online ISBN: 978-3-662-61074-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation