This has been on my mind recently after talking with people who have injured their shoulders. I was hoping that this will give you some clarity on what is going on and how we can help.
Let’s first explain normal shoulder movements. Firstly, your shoulder is an incredibly mobile joint. It allows you to reach high above your head, reach behind your back and behind your head. All this movement is facilitated by a ball and socket formed between the upper arm (humerus) and your shoulder blade (scapula). For instance, think of your shoulder like a golf ball on a tee – it has a large ball centred on a very small socket. Unfortunately, this makes the shoulder less stable and vulnerable to injury. Essentially, the shoulder is kept stable by the surrounding muscles (your rotator cuff) and ligaments, the glenoid labrum (a rim of fibrocartilage tissue designed to deepen the socket), and by the joint capsule.
Shoulder instability affects around 2% of the population. It is characterised by excessive movement of the ball within the socket causing pain and dysfunction. So, what causes your shoulder to be unstable? Generally, trauma such as shoulder dislocation or repetitive microtrauma (from swimming, throwing or serving in tennis) compromises the stabilising structures in your shoulder. Have you ever seen an athlete pop his shoulder back in after a heavy tackle?
So how do I tell if I have shoulder instability?
Shoulder instability is often described as a feeling that your joint is “loose or giving way”. You may also feel pain in the front, side or back of the joint. Additionally, you may also be avoiding certain shoulder movements due to pain or apprehension. In some cases, you may have a “dead arm” sensation or tingling down the arm. It is important to note that recurrent dislocations of your shoulder may make your stabilising structures lax and thus leading to shoulder instability.
A Physiotherapist will be able to help reduce your pain and improve your function. It is also important that you strengthen your rotator cuff and shoulder blade muscles to improve your stability. If you’re someone that has experienced multiple shoulder dislocations, further investigation may be required. Your Physiotherapist can provide a thorough assessment of your shoulder and provide a management plan for you.
Are you’re experiencing shoulder pain and are not sure where to start? I would love to chat with you personally about your shoulder. Send us an email at firstname.lastname@example.org. I’ll be more than happy to discuss with you further how we can help find the best management for you.
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(Please keep in mind, these are general guidelines for the majority of our patients. It is important to consult with your doctor or physiotherapist first and make sure you have a plan tailored specifically for you).