The Shoulder

instability

Diagnosis of minor gleno-humeral instability

History

Is there a traumatic onset? Fall on the abducted arm? forced abduction, forced extension - external rotation?

Recurrent, sudden and stabbing pain in the shoulder with subsequent and momentary functional loss, the so called dead arm syndrome, during overhead activities (service in tennis, smash, free style swimming).

A-traumatic, minor instability may be one of the underlying causes for recurrent tendinitis or bursitis. In recurrent rotator cuff problems, minor instability must always be sought.

Physical Examination

The basic functional examination may show some abnormal findings, typical for a possible minor instability:

• Enlarged range of movement(ROM)
• (to) Soft or 'double' endfeel.

If a minor instability is suggested, the classical stress tests to challenge the stability of the joint in various directions must be performed. These are:

1. anterior apprehension in supine position
2. anterior apprehension standing
3. posterior apprehension
4. anterior drawer
5. posterior drawer
6. relocation test
7. sulcus test

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[A System of Orthopaedic Medicine]

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