The shoulder is an inherently unstable joint and depends on the surrounding muscles, capsule and ligaments for support and stability. These structures may be congenitally loose or damaged as a result of injury.
This can lead to excessive movement of the end of the arm bone in the socket, or if due to a high-energy injury (e.g., fall or tackle during sports), a dislocation of the joint. The latter injury may be associated with damage to the nerves and blood vessels of the upper limb, and require urgent medical attention.
In an acute injury, the following symptoms may be present:
Some people may feel instability of the shoulder joint and the sensation of the shoulder ‘popping out’, occurring with specific activities or positions of the arm, such as throwing a ball or reaching behind the body.
Besides a thorough history and physical examination to establish the cause, extent and severity of the problem,investigations such as x-rays, ultrasound scans, magnetic resonance imaging (MRI), or computed tomography (CT) scans may be done to assess its severity and/or exclude injuries to the surrounding structures. This will also help with selecting the appropriate course of treatment.
The goal of therapy is to achieve shoulder motion and stability and increase rotator cuff muscle strength. If the shoulder remains unstable despite a course of strengthening physical therapy and activity modification, surgery to stabilise the shoulder joint may be needed.
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