Shoulder Instability

Question 1

What is the pathology of shoulder instability?

Answer 1

Disruption of static and dynamic GHJ stabilisers
Dynamic- RC, scapular stabilises
Static- articular conformity, negative intra-articular pressure, labrum, GH ligaments
Traumatic or autraumatic
Anterior, Posterior, Inferior, Multidirectional

Question 2

What is the clinical presentation of shoulder instability?

Answer 2

Clicking/pain
Possible sub-acromion signs (painful arc or rotation)
Possible RC signs - resisted tests, pain on rotation
Possible apprehension/ relocation test - anterior
Increased accessory movement
Positive sulcus sign test

Question 3

What is the sulcus sign test?

Answer 3

With the arm straight and relaxed to the side of the patient
The elbow is grasped and traction is applied in an inferior direction
With excessive inferior translation
A depression occurs just below the acromion

Question 4

How do you manage an shoulder instability?

Answer 4

Education
Motor Control
Proprioception training
Strength training
Surgery - depends on structural impairments