Dr. Clint Woo, DPT, PT
The General Game Plan for Shoulder Instability
Shoulder instability refers to when the your shoulder is susceptible to dislocation even with seemingly everyday movements and activities. The shoulder has an incredible amount of movement, but that also makes it vulnerable to more problems (think about an expensive car with the newest engine set up and tech features....a lot of things that could go wrong for the price of having all those extra goodies). Unfortunately once you dislocate a joint, it is more likely to dislocate again.
So what can cause shoulder instability? Impact, overuse, and anatomy can all be contributors. Some people also present with disorders such as Ehlers-Danlos syndrome (several types), one of which can lead to joint laxity and hypermobility. Others can present with shoulder instability after a stroke where the shoulder muscles (namely the rotator cuff) lose their natural baseline contraction thus not being able to support the weight of the arm in its socket. The weight of the arm can become too much for just the ligaments to handle on their own.
There are different degrees to dislocation just like there are with tears of muscles/tendons and ligaments. In general you may hear subluxation where the humeral (arm bone) head is partial dislocated vs a complete dislocation when the humeral head has completely come out of the socket.
So what to do about an unstable shoulder? First we can work with the foundation being your posture. A PT can help you understand what about aspects of your anatomy we are able to work around and how to best situate your posture. In general, a retracted chin/shoulders will allow for the shoulders to sit in their most ideal position (like a soldier sitting/standing tall). Then we can work on strengthening the shoulder. It's likely there is weakness for the shoulder in all directions, but strengthening external rotation in particular helps as over time you won't need to put as much effort to keep your shoulders back in the ideal location. Exercises such as working the rotator cuff, lats, and deltoids are all excellent to increase shoulder stability. Manual therapy can be useful to find which muscle are being overworked which means overtime, they will stop doing their job effectively! Finally taping is an excellent option as well. After the PT assess you, they can see if the tape would benefit from a lower-support/high stretch tape like rocktape or a more restrictive yet supportive tape like leukotape. Some have reported the benefits of using a certain type of sling, but research shows that it is not as clear as once thought.
It's always helpful to know what you're dealing with when it comes to instability so contact us to learn more about how we can help!
This is not intended to be professional advice. Please speak with a physician or physical therapist. Invest in yourself by bring the physical rehab to your home! We at Woo Physical Therapy and Wellness are proud to serve the Anne Arundel, Howard, and Prince George's counties in-home and online anywhere in the U.S.A. for wellness!!
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