External signs of instability of the shoulder joint. Damage to Bankart. Treatment of shoulder instability. Rehabilitation after treatment of habitual shoulder dislocation

Injury to the anterior labrum is called a Bankart injury. The lip of the shoulder performs a shock-absorbing function, while simultaneously fixing the bone in the shoulder socket. In cases where the lip is torn or torn, the stability of the bone entry is reduced. This occurs against the background of a dislocation and inevitably leads to disruption of the stability of the shoulder joint as a whole.

Reasons for appearance

There are two main causes of Bankart injury to the shoulder joint:

acute injuries;
long-term physical activity.

Athletes involved in athletics are at risk. Golfers are susceptible to shoulder dislocations. Naturally, the risks are reduced if training takes place under the watchful supervision of experienced trainers.

Dislocation and rupture can occur when you fall on your arm or receive a strong blow to your shoulder. Strong rotational movements of the arms and sudden lifting of heavy objects can also cause Bankart injury.

Oddly enough, a sedentary lifestyle can also cause damage to the shoulder joint. Some diseases cause the labrum to weaken and Bankart damage occurs (this may be arthrosis, tendinitis or osteoporosis).

Classification of pathology

Bankart damage is divided into three types:

Classic type. In this case, there is a complete separation of the articular lip from the scapula cavity. Usually, when a rupture occurs, a characteristic click is heard and pain and discomfort immediately appear.
The second type is characterized by the absence of joint rupture. If this type of pathology is not treated, the disease will worsen and lead to more serious consequences.
Extreme type. In this case, in addition to the rupture, there is also a bone fracture. In this case, serious medical treatment is required.

Symptoms

Bankart injury of the shoulder joint causes severe pain. The pain may be aching or intense. It all depends on the extent of the damage and the severity of the rupture. lips may be partial or complete.

The main symptoms include:

pain when moving the hand;
the limb, as a rule, functions poorly;
when bending the arm, characteristic clicking sounds appear;
the hand loses almost completely its ability to work.

Therapeutic measures

Treatment of a Bankart injury, if the injuries to the joint and lip are minor, can be done conservatively. In parallel with this, physiotherapy and fixation of the shoulder joint are used. Although it should be remembered that conservative treatment provides a positive prognosis for complete recovery only in 50% of cases. There is a high probability that instability of the shoulder joint will be observed in the future.

Surgery

Surgery can be open or arthroscopic.

Recovery after arthroscopic surgery is much faster and muscle strength is better restored. However, the risk of relapse after such an operation is very high when compared with open surgery.

Rehabilitation

The result of treatment for Bankart damage largely depends on rehabilitation measures, even more than on the type of treatment. The main role in this is played by the choice of tactics of restorative procedures. There are no special exercises for treatment; the rehabilitation program depends on many factors, in particular the degree of pathology, neglect and methods of treating the disease. Although the programs that are used after surgery and conservative therapy are very similar.

The first stage of rehabilitation involves immobilization using an orthosis. The patient will have to reduce their range of motion in the injured shoulder for approximately 1 to 4 weeks. helps avoid shoulder dislocation. If there is no pain, then passive movements are allowed from the fourteenth day of immobilization. The patient is then prescribed isometric exercises.

The second stage involves an increase in the number of passive movements, and active exercises are gradually included. The program then includes exercises aimed at strengthening the rotator cuff.

At the third stage, rehabilitation measures are aimed at restoring all movements in the shoulder joint. Dynamic exercises are used to increase shoulder resistance.

The patient must understand that rehabilitation after damage to the labrum is a long-term procedure, but following all the recommendations of the physiotherapist will gradually relieve all pain and restore full mobility of the arm. In some cases, rehabilitation therapy lasts about twelve months. Lifting weights after rehabilitation is possible only after three months.

The most complete answers to questions on the topic: "instability of the shoulder joint."

Shoulder instability is a fairly common condition that is characterized by weakening of the connective tissue (ligaments and joint capsule) surrounding the shoulder joint and, therefore, the bones that form the joint have an excessive range of motion.

The shoulder joint has a ball joint structure. The glenoid fossa of the scapula forms the rosette of the joint, and the head of the humerus forms a spherical support. The head of the humerus and the glenoid cavity are surrounded by dense connective tissue called the joint capsule and its associated ligaments. Additionally, a group of muscles called the rotator cuff covers the shoulder joint and helps hold the joint in place and increases joint stability.

When performing certain arm movements (such as throwing or falling on an outstretched arm), tensile forces are applied to the joint capsule or ligaments. When these forces are excessive or repeated frequently, stretching or tearing of the connective tissue can occur. As a result of this damage, the connective tissue loses its strength and the function of supporting the shoulder joint is reduced, which in turn leads to an excessive increase in the range of motion in the shoulder joint (shoulder instability). Instability of the joint can lead to the head of the humerus slipping out of the glenoid cavity or to dislocations (subluxations and dislocations). Typically, shoulder instability occurs in one shoulder. But sometimes instability can occur in both joints, especially in patients with inherently weak connective tissue or in patients who have performed repetitive, excessive movements of both arms (such as swimmers).

Causes

Shoulder instability most often occurs after a traumatic episode in which partial or complete dislocation of the shoulder occurs (for example, a fall onto the shoulder or an outstretched arm, or due to a direct blow to the shoulder). Quite often such injuries occur in contact sports such as football or rugby. This usually occurs with a combination of shoulder abduction and excessive external rotation. Shoulder instability can also develop gradually over time and is caused by repeated significant loads on the shoulder joint when performing movements that stretch the connective tissue structures of the joint (throwing or swimming). In addition, the development of instability is facilitated by impaired biomechanics of movements, poor technique and is most often found in athletes who need to move their arms above their heads (baseball players, javelin throwers, cricket players, tennis players). Shoulder instability can also be caused by congenital connective tissue weakness (joint hypermobility).

Factors contributing to the development of shoulder instability

There are a number of factors that can contribute to the development of shoulder instability and associated symptoms. Studying these factors allows the rehabilitation physician to better carry out treatment and avoid relapses of instability. These are mainly the following factors:

history of episodes of shoulder dislocation (dislocations or subluxations)
inadequate rehabilitation after shoulder dislocation
intense participation in sports activities or excessive stress on the shoulder
muscle weakness (especially the rotator cuff muscles)
muscle imbalance
impaired biomechanics of movements or sports techniques
rigidity of the thoracic spine
shoulder hypermobility
ligamentous weakness
muscle stiffness due to poor posture
changes in training
bad posture
insufficient warm-up before playing sports

Symptoms

Patients with shoulder instability may have few or no symptoms. With atraumatic shoulder instability, the first symptom may be partial shoulder dislocation or pain in the shoulder during or after performing certain movements. With post-traumatic instability, the patient usually reports the presence of specific painful injuries that caused problems in the joint. Usually we are talking about dislocation (dislocation or subluxation), often this occurs with a combination of abduction and external rotation during injury. After an injury, the patient may experience pain during certain activities and also afterward while resting (especially at night or early in the morning). In addition, the patient experiences sensations in the shoulder that he has not observed before.

Patients with shoulder instability may notice a clicking or other sensation in the shoulder when performing certain movements. The patient may also notice decreased muscle strength in the affected shoulder and a feeling of weakness during certain movements (for example, moving an arm overhead). Patients may also experience tenderness in the anterior and posterior aspect of the shoulder joint and a fear of dislocating the joint when performing throwing movements. Patients may also experience pain and a feeling of joint displacement when sleeping on the affected side. In severe cases of shoulder instability, patients often experience repeated episodes of subluxation or dislocation of the joint. These episodes may be accompanied by pain, sometimes complete numbness of the shoulder, which usually lasts a few minutes. In these cases, or in cases of multivector shoulder instability, patients may self-inflict dislocation. In more severe cases, dislocations can be caused by even minimal movements, such as yawning or turning over in bed.

The shoulder joint is characterized by natural increased mobility, since it does not have its own ligaments. The attachment of the humerus to the glenoid cavity of the scapula is carried out using only one ligament, which connects to the coracoid process of the scapula, woven into the capsule. The articular cavity is shallow, flat oval in shape, limited by tubercles along the perimeter of the articular labrum. Its area is approximately three times smaller than the area of the head of the humerus, which is held in the socket due to the force of the rotator cuff muscles covering the joint. But sometimes the head of the humerus can slip out of the socket. This phenomenon is called instability. In what cases does shoulder instability occur?

What Causes Shoulder Instability

The two main causes of an unstable shoulder are traumatic avulsion of the capsule, sometimes along with the labrum, and chronic strain of the coracobrachial ligament and capsule.

Traumatic rupture or atrophy of the rotator cuff, which plays the role of a shoulder stabilizer, can also lead to disturbances in the stability of the shoulder joint.

Shoulder instability in ICD 10

In the international classification of diseases of the ICD, instability of the shoulder joint due to injury or sprain of the capsule and ligament belongs to the group of diseases M24.2.

In addition to this, there are:

Pathological dislocations/subluxations of the shoulder - classified under code M24.3.
Repeated (habitual) dislocations and subluxations - M24.4.
Instability for other reasons - M25.3.

In this article we will focus on instability M24.2 as the most common.

Traumatic damage to the capsule and ligament

Occurs at the moment of strong and sudden pressure of the humeral head on the capsule for reasons:

a sharp blow to the shoulder area;
excessive external rotation;
hyperextension and hyperextension;
falling on outstretched arms.

The injury causes the humeral head to move anteriorly, posteriorly, and inferiorly.

Shoulder instability caused by injury is called single-plane instability.

Clinical symptoms:

patients feel pain, especially when raising their arms above their heads;
movements are preserved due to muscles;
at the time of injury, a slight cracking and crunching sound may be heard;
Shoulder swelling and hematoma may appear in the first hours after injury.

Traumatic instability can only be eliminated surgically. If this is not done, chronic instability will occur, in which the head of the humerus will periodically move out of the joint. This phenomenon is called habitual dislocation (with complete protrusion of the head) or habitual subluxation (with partial disruption of the contact of the articular surfaces).

Diagnosis of single-plane instability

The doctor examines the shoulder area using standard tests (tests) that help classify instability.

Anterior instability test

The patient's arm, bent at the elbow, is abducted 90°.
Then external rotation is performed with simultaneous pressure from behind on the shoulder - as if simulating an anterior dislocation.
If there really is instability, the patient experiences unpleasant sensations as before a dislocation: he tenses, expecting pain, and changes his facial expressions. The patient’s internal anxiety is transmitted to the arm muscles: they become toned.
When pressing from the front on the shoulder during external rotation, the patient immediately calms down, since no unpleasant feelings arise anymore, simply because with this movement the doctor moves the head of the shoulder into place.

Posterior instability test

Testing occurs in several ways, since posterior shoulder instability is more difficult to diagnose:

The first test is performed with the arm in the same position as the anterior instability test, but the direction of rotation and pressure is reversed: internal rotation and anterior pressure on the shoulder.
The second swing test is carried out with wide amplitude movements of the affected hand:
- the patient is asked to turn the limb inward and make a swinging movement in the opposite direction;
- then from this position the arm is consistently extended forward, moved to the side, turned outward and lowered down;
- Throughout the entire test, the doctor holds his fingers on the shoulder joint, analyzing the behavior of the humeral head - its backward displacement during the swing movement and internal rotation, and its reduction during the reverse movement and external rotation give a positive test of posterior displacement.
Junk test:
- the patient raises his hand straight in front of him, and the doctor pulls it back;
- then applying pressure from behind the shoulder, the surgeon bends the patient's arm at the elbow and slowly lowers the shoulder - a click during this movement indicates reduction of the head and confirms posterior instability.

Test for lower instability (Khitrov’s symptom)

It is performed with the patient sitting. The test is very simple:

the doctor takes the patient’s hand and pulls it down;
with a positive result, that is, in the presence of lower instability, a deep groove appears under the scapular acromion;
During the test, the patient feels pain or discomfort and a premonition of dislocation.

But Khitrov’s symptom is not decisive for the diagnosis of traumatic single-plane displacement, since it is also observed in chronic instability caused by hyperextensibility of connective tissues.

Chronic sprain of the ligament and capsule of the shoulder joint

This problem is most often of a hereditary type: from birth, some people have all their connective tissues more elastic than those of the healthy part of the population. The main reason is genetic mutations leading to impaired collagen synthesis. Overstretching of the ligaments leads to hypermobility of the joints, habitual dislocations and subluxations.

It appears more often in women, as well as in children and adolescents during periods of active growth. In this case, the displacement occurs not in one direction, but in several at once. When diagnosing, doctors notice during palpation the free movement of the head in different planes, which is why this type of instability is called multiplanar.

Chronic shoulder instability can also result from:

improper training in athletes, when uncontrolled loads and an intense training regimen lead to microtraumas in capsules and ligaments (this happens all the time among weightlifters, gymnasts, and bodybuilders);
congenital dysplasia of the shoulder muscles (they are underdeveloped and atrophied).

Symptoms of Chronic Shoulder Instability

One of the symptoms of chronic shoulder instability is frequent subluxation in all four directions.

Patients complain of pain and discomfort in the scapulohumeral region, sometimes burning sensations, tingling, and numbness. They are afraid to make sudden movements, as they constantly think that a dislocation will definitely happen.
The rotator cuff is in a state of chronic overstrain, which can ultimately lead to impingement syndrome - pinching of the rotator cuff tendon. Myositis (inflammation) of the muscle fibers of the cuff is periodically observed.
Patients feel tired and weak, and over time they develop muscle hypotonia and atrophy.

Diagnosis of chronic instability

Hypersprain is determined by:

By hypermobility of the joints of the hand, as well as the knee and elbow. One positive test is the ability to reach the wrist with the abducted thumb.
Positive tests of anterior, posterior and inferior instability (they confirm the diagnosis).
Using X-ray or MRI:
- pictures in two projections show a stretched capsule;
- functional radiography - displacement of the humeral head during movements.

Treatment of chronic shoulder instability

The main method of treating multi-cavitary chronic instability is conservative with the help of exercise therapy and fixation of the shoulder with an elastic bandage or orthosis.

Physiotherapy

Therapeutic stabilizing exercises are prescribed to strengthen the rotator cuff, stretch or strengthen the flexor, extensor, and abductor muscles.

The patient should be protected from exercises that provoke subluxation: it is necessary to exclude external rotation of the shoulder and its excessive abduction.

To strengthen the rotator cuff, exercises with an expander are recommended.
To stretch the shoulder muscles - exercises with a cane with a knob.
Strengthening the flexors, extensors and abductors is done using dumbbells: the arms should be positioned horizontally to the floor.

Bandages and orthoses

They help prevent displacement of the shoulder joint during training and stabilize the shoulder during habitual subluxations.

To limit rotation and excessive abduction of the shoulder, an elastic bandage is used, which is applied to the shoulder and chest areas and secured with a plaster.

About the shoulder joint

Shoulder joint - refers to the ball-and-socket joints, and is formed by the glenoid cavity, which is located on the scapula, as well as the head of the humerus. The shoulder joint is considered the most mobile and multifunctional among all the joints in the human body, because thanks to it we can carry out a large range of movements with our hands. The shoulder joint is a fairly large joint in the human body. That is why it has a powerful frame, in the form of ligaments and muscles, which reliably strengthen it and protect it from unnecessary damage. I would like to remind you that not only the muscles of the arm, but also the muscles of the chest and back are involved in the movement of the shoulder. That is why, if the above-mentioned muscle groups are damaged, the range of motion in the shoulder joint may be impaired.

Instability of the shoulder joint occurs when, when the muscles surrounding the shoulder joint do not perform their function fully, as a result of which the head of the humerus moves out of its usual position, i.e. from the center of the glenoid cavity. This condition, when the function of the muscular and ligamentous framework is disrupted and deteriorates, leads to frequent dislocations.

Instability of the shoulder joint is usually caused by a number of factors that negatively affect the ligamentous apparatus. Such factors may include injuries to the shoulder joint (especially chronic injuries), a genetic predisposition to weakness of the ligamentous apparatus in the body, and hypermobility of the shoulder joints. If there are predisposing factors to the appearance of instability of the shoulder joint, you need to be as careful and attentive to this problem as possible, taking care of your health.

Remember, the shoulder joints are of great importance in the work of the upper limbs. That is why, damaging the shoulder joint, or if there is suspicion of instability of the shoulder joint, do not hesitate to contact a specialized institution for medical help. The sooner you seek treatment, the sooner you will get rid of the disease!

Symptoms of shoulder instability

Symptoms of shoulder instability are mainly characterized by pain of varying intensity. If shoulder instability associated with dislocation, then the pain is usually intense, acute, which manifests itself due to damage and injury to the ligaments, joint capsule and other structures. If the dislocation is repeated, then the pain symptom is less intense than it was the first time. In addition to pain, the patient may complain of a characteristic click, which is associated with the exit of the head of the humerus from the joint cavity. Also, instability of the shoulder joint is manifested by the fact that the range of movements in the injured limb is limited, which is why the patient cannot perform all the usual movements of the arm in full.

Symptoms of shoulder instability usually occur after excessive physical stress on the upper extremities, or disproportionate load on them (for example, throwing a heavy object over a long distance without such training).

Also, please note that instability of the shoulder joint can lead to compression near the passing nerve bundles, which is manifested by impaired sensitivity and numbness of the injured hand.

Surgery for instability of the shoulder joint is performed free of charge as part of the VMP

If there are medical indications and there are referral quotas, our center performs operations using funds allocated under the program for the provision of high-tech medical care (HTMC)

Treatment of shoulder instability

Treatment of shoulder instability in our medical center carried out at the highest level, achieving good results, and in the shortest possible time. The whole secret of treatment with us is that we employ the best specialists who find a personal approach to each patient and provide first-class specialized treatment.

Treatment of shoulder instability in our center carried out using such a modern method as arthroscopy. This technique makes it possible to provide the patient with highly qualified care with minimal invasive intervention. Arthroscopy in this case can be a diagnostic or therapeutic procedure. Diagnostic arthroscopy allows you to accurately determine the damaged structures and determine the extent of surgical intervention.

Video - treatment of instability of the shoulder joint with shoulder dislocations, 1:44 min, 3 MB.

Therapeutic arthroscopy is performed to eliminate damaged joint structures, strengthen and stabilize it. Strengthening the joint and preventing the formation of joint instability in the future is carried out thanks to the creation by our doctors of tendon-muscular blocks that prevent displacement of the head of the humerus in a pathological direction. The rehabilitation period after arthroscopy is usually minimal and proceeds well for our patients.

Carrying out such treatment of shoulder instability allows the patient to rehabilitate, restore range of motion in the shoulder joint and forget about unpleasant symptoms. And most importantly, treatment in our clinic allows the patient to never encounter such ailments again, because the absence of recurrence of the disease is our goal.

Gradual instability of the shoulder joint can lead to sudden dislocation of the humerus. Before this episode, many patients do not even suspect that they have a similar musculoskeletal problem. After the initial episode of habitual shoulder dislocation, excessive stretching of the synovial cartilaginous capsule occurs due to its instability. As a result, the deformation of the labrum increases and episodes begin to recur more and more often.

The cartilaginous membrane of the head of the humerus quickly deteriorates. Chronic instability of the shoulder joint is the most common cause of the development of deforming osteoarthritis and glenohumeral periarthritis.

When the shoulder is unstable, a weakening of the tone of the cartilage and connective tissue occurs. This causes excessive stretching of the tendon and ligamentous tissue, which is designed to fix the position of the head of the humerus in the glenoid cavity of the scapula. Excessive mobility, ease of rotational movements, and too much abduction of the upper limb back behind the body may be observed.

The anatomy of the shoulder joint is quite complex. This is an articulation of bones of the hinge and ball type with a wide variety of movements performed. A person in a physiological state can rotate his arm, make flexion and extension, adduction and abduction movements. The joint is formed by the head of the humerus and the glenoid cavity of the scapula. On the outside, this joint is covered with a dense cartilaginous capsule. Inside it there is a synovial layer, which ensures easy sliding of the head of the bone in the articular cavity.

Mobility is provided by a group of muscles. Innervation is carried out using the radicular nerves and their branches. These muscles are called the rotator cuff. When sudden or excessive movements are made, the muscle tissue does not have time to resist and primary injury to the tendon and ligament tissue occurs. It deforms and stretches. An excessive amplitude of mobility of the head of the humerus appears in the articular capsule.

As instability of the shoulder joint develops, when a sudden or excessive movement of the upper limb is made, the head of the humerus comes out of the joint. A habitual dislocation occurs. In most cases, the pathology is unilateral. And in some patients the disease is bilateral. This is facilitated by the scope of professional activity or the presence of systemic connective tissue pathology.

If you have clinical signs of shoulder instability, contact your orthopedic doctor as soon as possible. At the initial stage, it is possible to overcome this disease using manual therapy methods. If the joint capsule is severely deformed, surgery may be required to restore its stability. The alternative is repeated episodes of habitual shoulder dislocation.

In Moscow, you can make an appointment for a free appointment with an orthopedist at our manual therapy clinic. At the first consultation, the doctor will conduct an examination and a series of functional diagnostic tests. After diagnosis, individual recommendations for additional examination and treatment will be given.

Causes of shoulder instability

Shoulder instability develops gradually. The rapid development of clinical symptoms can only be associated with a destructive process that is provoked by internal causes. For example, with joint dysplasia or chronic intoxication, destruction of cartilage tissue occurs.

In most cases, the trigger mechanism is the primary traumatic impact. It can be:

fracture of the head of the humerus followed by long-term immobilization of the upper limb;
dislocation of the shoulder with stretching of the joint capsule;
stretching and micro-tears of ligament and tendon tissue;
myositis due to bruise of the soft tissues of the shoulder.

With a direct strong blow to the shoulder, dislocation of the head of the humerus can develop. Therefore, instability is an occupational disease for athletes involved in wrestling, boxing, etc. The risk zone includes football players, hockey players, and rugby players.

Excessive mobility and rotational activity due to abduction during excessive physical activity leads to a gradual stretching of all connective and muscle tissues. Hypermobility can be congenital or acquired. Any inflammatory processes in the joint area lead to deformation and thinning of the cartilaginous synovial layer. The result is an unstable position of the humeral head in the joint capsule.

Potential causes of shoulder instability include the following risk factors:

dislocation of the head of the humerus during subluxation or complete dislocation);
improper treatment after a shoulder fracture;
degeneration of muscle tissue due to disruption of innervation processes, including cervical osteochondrosis with radicular syndrome;
destruction of cartilage tissue due to osteoarthritis, arthritis, hypoplasia and angiopathy;
excessive physical stress on the shoulder joints, including improper strength training;
rigidity of the muscular frame of the back and collar area;
tunnel syndromes of the upper limb (cubital, carpal, carpal, etc.);
consequences of poor posture, most often the cause is severe scoliosis in the thoracic region and the formation of a widow’s hump in the area of the sixth cervical vertebra;
decreased elasticity of ligament and tendon tissue against the background of biochemical pathological processes in the human body, including hormonal disorders;
chronic inflammatory processes in the human body;
improper organization of sleeping and working spaces.

Elimination of all possible causes of shoulder instability is a preliminary measure necessary for successful subsequent treatment.

Posterior instability of the right shoulder joint

Posterior shoulder instability is relatively rare. This is due to the special structure of the shoulder joint. Often acute dislocation occurs when the labrum is destroyed. It limits the mobility of the humeral head in the anterior plane. Therefore, there are no anatomical prerequisites for the posterior location of the pathological process.

Multiplanar or posterior instability of the right shoulder joint occurs in people who are forced to perform professional functions with their arms raised high. Clumsy movement or excessive physical exertion may lead to an initial episode of acute posterior dislocation. Against this background, secondary inflammation occurs. When the joint capsule is severely stretched, hemarthrosis can occur. If timely measures for treatment are not taken, then episodes will be repeated in the future. Ultimately, habitual dislocation and chronic instability of the shoulder joint will form.

Symptoms of shoulder instability

At the initial stage, no clinical symptoms of shoulder instability may appear. Pain can only occur with a traumatic etiology of the disease. Primary signs may appear randomly when, when performing certain movements, the patient notices excessive mobility of the head of the humerus.

As the articular cartilage tissue deforms, pain occurs. In most cases, pain is a symptom of the development of secondary forms of musculoskeletal diseases. Diagnosis often begins with the patient contacting an orthopedist regarding the development of arthritis, arthrosis or glenohumeral periarthritis. During examinations, instability of the shoulder joint is randomly detected.

The second option for the development of the clinical picture:

Gradual damage to the joint capsule and its excessive stretching;
Increasing the amplitude of mobility;
Weakening of the rotator cuff muscle fibers;
Development of acute dislocation when making awkward or excessive movements of the upper limb.

The second option occurs in approximately 40% of clinical cases. The remaining 60% of patients experience discomfort in the shoulder area for a long time. They may occur in the morning or worsen in the evening when going to bed. This may be accompanied by extraneous sounds in the form of clicks and crunching when performing rotational movements with the hand. With the long-term development of pathology, the activity of the muscle fiber decreases and its blood supply is disrupted. Dystrophy begins with loss of physiological functions. A feeling of muscle weakness that increases when you raise your arm up is an unfavorable clinical sign. He speaks of a serious degree of excessive stretching of the joint capsule.

During examination, the orthopedic surgeon, using palpation and manual examination, can identify deformation of the shoulder joint, incorrect position of the head of the humerus when making arm movements. Palpation is painful. With multivector instability, innervation is disrupted - areas of paresthesia and lack of skin sensitivity of the upper limb may be detected.

For diagnosis, an examination performed by an experienced orthopedic surgeon is sufficient. X-rays and MRI are prescribed to exclude concomitant diseases associated with the destruction of cartilage, muscle, bone and ligament tissue.

Treatment of shoulder instability

For complex treatment of instability of the shoulder joint, temporary immobilization of the upper limb, reduction of physical activity, the use of reflexology methods, kinesiotherapy, physiotherapy, osteopathy and massage can be used.

You can contact our manual therapy clinic. Experienced doctors will develop an individual course of therapy for you.

The following treatment methods are often used for treatment:

massage of the affected area in order to improve microcirculation of blood and lymphatic fluid - thus stopping the process of muscle fiber dystrophy and increasing the elasticity of connective and ligamentous tissue;
osteopathy - restores the normal structural structure of the shoulder joint and improves innervation processes;
physical therapy and kinesiotherapy are aimed at strengthening the rotator cuff, which is responsible for fixing the head of the humerus;
reflexology starts the process of restoration of damaged tissues;
physiotherapy, laser treatment and electrical myostimulation can achieve a positive effect much earlier.

Surgery for shoulder instability may be necessary if manual therapy does not provide relief.