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July 08, 2008  
EDUCATION CENTER: Shoulder Conditions
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  • Instability

    Quick Reference

    Reviewed by Dr. Peter Simonian

    The shoulder is the junction of three bones: the humerus (upper arm bone), the clavicle (collarbone), and scapula (shoulder blade). The ball-like head of the humerus fits into the cup-like end of the scapula known as the glenoid. This junction is commonly referred to as the shoulder socket, and is stabilized in part by the shoulder capsule, a series of ligaments that connects the humerus to the glenoid. When the ligaments weaken, the shoulder has a greater tendency to dislocate. This is known as instability, which can lead to greater and more painful shoulder conditions, especially dislocation and subluxation.

    Detailed Description

    Symptoms

    Dislocation and subluxation are the telltale signs of instability. If either happens frequently, instability is usually to blame. Usually, a substantial blow to the shoulder can be identified as the start of the condition. Also, if the patient feels the shoulder suddenly give way or describes it as “unreliable,” this may mark instability.

    Causes and Risk Factors
    Causes

    Often an initial subluxation or dislocation forces the ligaments of the shoulder capsule to stretch. If the initial condition does not heal properly, instability will result and worsen over time.

    Risk Factors

    Overhead sports, such as baseball, volleyball and swimming, pose a great risk of instability. Additionally, those with above-average joint laxity, or looseness of the ligaments, stand at great risk of shoulder instability.

    Treatment

    Immediate Treatment

    Follow procedure for dislocation or subluxation, depending upon injury that occurred.

    Procedures

    An orthopedic surgeon has a number of procedures at his or her disposal to remedy chronic instability. All involve tightening the ligaments within the shoulder capsule. The procedure may be performed in an open or arthroscopic fashion. Thermal shrinkage may also be used.

    Medications

    Prescription and non-prescription painkillers and anti-inflammatory agents.

    Prevention

    Strong rotator cuff muscles remain the best defense against shoulder dislocation, subluxation, and, thus, instability. Exercises that build up these muscles around the shoulder should be done. Adequate warm-up before activity and avoidance of high-contact sports will help prevent of an instability-causing injury.

    Last updated: 10-Oct-00

       
     
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