Rehabilitation for shoulder instability

Abstract

Both structural and non-structural components can contribute to shoulder instability. Classification and therefore management must recognise these factors to achieve functional stability. This paper discusses a classification system proposing three types of shoulder instability recognising the structural and non-structural components and that a continuum exists between pathologies. Structural causes can be addressed with surgical intervention, but non-structural causes such as altered neuromuscular control within the rotator cuff should be addressed conservatively. The purpose of this article is to describe the types of instability and guide appropriate management, helping to avoid surgery in inappropriate cases and ensure that effective rehabilitation has been achieved.

BESS/BOA Patient Care Pathways

“…This has also been referred to as Type 1 instability (Figure 1) on the Stanmore triangle of instability. 1 …”

Traumatic Anterior Shoulder Instability: Part I. General Concepts and Proper Management

“…Range of motion of the elbow, wrist, and hand is permitted immediately. Then, closedchain exercises facilitate rotator cuff function to enhance joint stability and stimulate muscular coactivation and proprioception [ 90 ]. For throwing athletes, a program is initiated and advanced, beginning at 3 months.…”

Multidirectional instability of the glenohumeral joint: an unstable classification resulting in uncertain evidence-based practice

“…Focus on the functional analysis: quality of arm movement, neuromuscular control affecting shoulder stability, kinematics of the glenohumeral and scapulothoracic joint, and core stability. These core components are well known,10 but the challenge is how to put them all together.…”