THE UNSTABLE SHOULDER
The shoulder is the joint with the greatest range of motion; it is made up of the humerus, shoulder blade and clavicle.
The head of the humerus, of spherical shape, articulates with the scapular glenoid which has the form of a blade-shoe. The ligaments, interconnecting these two structures allow the movement.
What is shoulder instability?
When the motion is excessive we can speak of shoulder instability. The most common episode is the shoulder dislocation, which happens when the humeral head disarticulates completely the margin of the glenoid.
How does shoulder instability originate?
The dislocation occurs more frequently as a result of a fall with a posteriorly extended and extra rotated arm.
Often, after a first episode of dislocation, minor traumas can lead to further episodes of instability.
What are the symptoms?
The pain is the main symptom, in the case of a dislocation it is very accentuated and accompanied by functional impotence with alteration of the typical shoulder profile, while in other types of instability symptomatology is less important and looks appears only following specific movements with a typical feeling of insecurity.
What are the injuries that determine an unstable shoulder?
The shoulder instability is normally supported by an inability of the ligamentous structures to perform their function. Other types of instability are undoubtedly less frequent.
In front of an unstable shoulder it is of crucial importance to get an accurate diagnosis that will direct to the most appropriate treatment.
How is it diagnosed?
A specialist examination is necessary that will be followed by radiological insights and especially by the RMI.
How does the instability get cured?
The instability is usually treated in first instance through a fisiokinesiterapic-rehabilitative program.
Other times, a surgical approach may be necessary.
Arthroscopically, in most cases it is possible to repair damaged structures anatomically restoring their functionality.
These techniques have a definite advantage given by the laying invasiveness, which is also reflected in better esthetic results than the classic interventions; however, they play today a key role in cases of particularly serious instability.