Anterior instability of the shoulder can also be chronic during weight training. Several errors of technique can contribute to anterior instability. Behind the neck (latissimus dorsi) pull-downs load the shoulder at the extreme of external rotation; shoulder hyper-extension during the bench press produces repetitive shoulder capsule trauma and places excessive traction on the AC joint; and behind the neck military presses stress the shoulder capsule, the rotator cuff, and the inferior shoulder ligaments. The patient may report vague symptoms such as a feeling of looseness of the shoulder or transient numbness of the arm.

shoulder instablility

Patients with instability usually do not have any symptoms. When symptoms occur, they often are the result of a sudden traction on the arm that results in pain and weakness felt in the entire arm. Supporting the arm relieves symptoms. Another common presentation is difficulty working in overhead positions due to a sense of fatigue rather than pain. Most patients have an inherent looseness to their shoulder capsule (born loose). This may be accentuated by sporting activities that constantly stretch the capsule, such as with throwing sports and swimming.

Treatment of anterior shoulder instability is still somewhat controversial. An aggressive Functional Rehabilitation program is advocated involving scapular stabilization, rear deltoid (shoulder) and external rotator cuff strengthening to substitute for the laxity of the joint capsule and prevent future dislocations. Targeted Soft Tissue Therapy is performed to breakdown the scar tissue formation from the chronic overuse. In an overhead throwing athlete or high shoulder demand athlete, however, a case can be made for early evaluation for consideration of surgical repair. Avoidance of positions that further stretch the capsule is important. Surgical stabilization is rarely necessary.

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