The shoulder is a complex and remarkably mobile joint. It allows us to orient our hand in space. However, the shoulder can sometimes be affected by instability: a pathology Painful and debilitating on a daily basis, shoulder instability usually occurs following a dislocation. In this article, we will explain what shoulder instability truly is, its symptoms, and the various treatments used to address this type of condition and minimize the risk of recurrence.
What is shoulder instability?
Frequently subjected to stress in three areas during daily activities (sports, basic movements, etc.), the humerus can sometimes subluxate or dislocate from the glenoid cavity of the scapula, which normally stabilizes it. In this situation, the capsuloligamentous structures that also ensure joint stability can stretch or rupture. This condition is then considered a shoulder dislocationwhich can lead to shoulder instability.
Shoulder instability is a painful condition that can significantly impact the daily life of the patient who suffers from it. Movements that are normally easy to perform become difficult, particularly painful, and may be accompanied by clicking or popping sounds.
What are the symptoms of an unstable shoulder?
Shoulder instability presents with symptoms that are fairly easy to identify, which facilitates diagnosis and treatment of this type of disorder. These include:
- Severe shoulder pain: it is often described as bothersome and sharp, especially when performing everyday movements (dressing, cleaning, washing dishes, etc.). The pain can also prevent the patient from engaging in physical activity involving the use of their arms. It should be noted that the pain may tend to disappear at rest.
- a sensation of a shoulder that is cracking or giving way;
- episodes of recurrent dislocations and therefore apprehension in the subject: the latter hesitates to perform certain movements for fear of dislocating the shoulder again.
Shoulder instability: the different causes and risk factors
There are two main causes involved in shoulder instability:
- muscle dysfunction: generally observed in hypermobile individuals who have potentially never suffered shoulder dislocations, but have been prone to subluxations;
- Traumatic origin: this instability results from an accident which may also be favored by the patient's genetic predisposition.
It is important to keep in mind that having previously experienced a shoulder dislocation (especially if it occurred before the age of 30) is a significant risk factor to consider. Indeed, if a patient suffers a dislocation later in life (after age 50, for example), they are less likely to experience a recurrence involving further shoulder instability.
Because it remains the primary cause and a risk factor for shoulder instability, it is essential to understand what can contribute to the risk of dislocation. These causes include, but are not limited to:
- the practice of a sport which puts the shoulder joint under very large ranges of motion: handball, basketball, combat sports, etc.;
- the practice of a professional activity requiring the recurrent use of the shoulder;
- the genetic dimension (ligamentous hyperlaxity).
How to diagnose shoulder instability?
A diagnosis of shoulder instability can be made following a clinical examination and/or an imaging examination.
In the first scenario, the doctor performs a palpation and interviews, which will provide them with a great deal of information about the patient's condition. During this examination, the healthcare professional can also identify any deformity or muscle atrophy of the shoulder, as well as the various points of pain experienced by the patient.
Generally, an imaging examination confirms and complements the diagnosis previously established by the doctor. An X-ray also helps identify any fractures. Furthermore, it is important to note that an MRI is usually prescribed to assess the extent of the damage in cases of recurrent shoulder dislocations.
What treatment is available for shoulder instability?
An unstable shoulder is treated by stabilizing the joint. To do this, healthcare professionals generally consider two options:
Surgical intervention remains reserved for instabilities of traumatic origin. In such cases, the patient may also be advised to undergo a few physiotherapy sessions before considering surgery. Indeed, in some cases, muscle strengthening exercises, education, and proprioception-based training can sometimes prove sufficient to stabilize a shoulder.
Physiotherapy is primarily considered in cases of instability of muscular origin. In this specific case, depending on the doctor's diagnosis, several physiotherapy sessions should be prescribed to strengthen the shoulder muscles and prevent recurrence by educating the patient on the correct movements to perform.
How to prevent recurrences of shoulder instability?
Often, recurrent shoulder instability is observed in specific profiles (elite athletes or hypermobile individuals). To mitigate this risk, preventative physiotherapy sessions can be considered. These sessions aim to strengthen the shoulder muscles to ensure greater stability. In addition, an educational program focused on proper shoulder movements can also be implemented. Through proprioceptive exercises, this technique helps patients better understand how their joint functions and thus reduces the risk of shoulder dislocation.
The Allyane method in the treatment and prevention of shoulder instability
The Allyane neuromotor reprogramming method combines mental imagery, proprioception, and listening to low-frequency sounds to treat motor inhibitions, such as those caused by shoulder instability. Used in conjunction with physical therapy sessions, it addresses inhibitions that can prevent muscles from functioning correctly. Furthermore, the Allyane method helps patients relearn proper movement and overcome apprehension, thereby reducing the risk of recurrence.
Would you like to learn more about the Allyane method for treating shoulder instability? Feel free to contact a certified practitioner near you.