Shoulder Instability Or Dislocations

shoulder instability anatomy

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

Shoulder is the most mobile joint of the body. This allows you to lift your arm, rotate your arm and lift your arm over your head. It’s possible to have a greater range of motion with less stability.

How

Shoulder instability

This happens when the humerus head (the upper arm bone) is forced out of the shoulder’s cavity. Usually this happens as a result of a sudden traumatic injury.

Once the shoulder is dislocated, the shoulder is vulnerable to repeat. When the shoulder is loose and slips several times, it’s called a chronic shoulder instability.

The shoulder is made of 3 bones : humerus (upper arm bone), scapula (shoulder blade) and clavicle (collarbone).

Dislocation shoulder

shoulder dislocation anatomy

This may be partial, which means that the arm’s ball partially comes out from the cavity. This is called a subluxation. This can be complete which means that the arm’s ball comes out completely from the cavity.

Symptoms

Symptoms of chronic shoulder instability are :

  • Pain caused by the shoulder injury

  • Repeated shoulder’s dislocation

  • Repeated instance of the shoulder giving out

  • A persistent sensation of the shoulder that is loose, slipping out of the joint or hanging.

Diagnosis

Specific tests help assess shoulder instability (including general relaxation of ligaments). A doctor may prescribe imaging tests such as X-rays, CT Scan or MRI to confirm the diagnosis and identify other problems.

Treatment

First, chronic shoulder instability treated with nonsurgical options. If these options don’t relieve pain and instability, surgery may be needed.

Nonsurgical treatment

shoulder dislocation treatment non surgical

Generally, it often takes several months of nonsurgical treatment before success can be assessed. Nonsurgical treatments includes :

  • Activity modification

  • Non-steroidal anti-inflammatory medication

  • Physical therapy

Surgical treatment

shoulder dislocation treatment surgery bankart repair

Often, surgery is often required to repair torn or stretched ligaments so that they can maintain the shoulder joint in place.

Bankart lesions (tearing of the front labrum from the cavity) can be repaired surgically using suture anchors to reattach the ligaments to the bone.

Arthroscopy => Soft tissues of the shoulder can be repaired using tiny instruments and small incisions. It’s a procedure that is done the same day or outpatient. Arthroscopy is a minimally invasive surgery. The surgeon examines the inside of the shoulder with a small camera and performs the operation with special instruments.

Open surgery => These are patients who require open surgical intervention. This involves making a wider incision on the shoulder and performing the repair under direct visualization.

Rehabilitation

After surgery, the shoulder can be temporarily immobilized with a sling. When the sling is removed, it’s essential to do ligament rehabilitation exercises. These exercises improve the range of motion of the shoulder and avoid scarring during ligament healing. Thereafter, exercises for strengthening the shoulder will be added in the rehabilitation program.

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-Steph

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Hanging Leg Raises

hanging leg raises

What’s up ? This is THE stephane ANDRE ! I read a Frederic Delavier’s book « Strength Training Anatomy » and I learned good stuff.

Suspended on a chin-up bar :

  • Inhale and back up your knees as high as possible by approaching your knees to your torso.

  • Exhale at the end of the movement

This exercise works :

  • The iliopsoas, rectus femoris, tensor fasciae latae when you raise your legs.

  • The rectus abdominis and a little less obliques work when you move your knees to your torso.

To target the work on abs, it’s advisable to make small oscillations of thighs without never having the knees below the horizontal.

Attention

Rotations of the torso to the machine are proscribed for people suffering from low back or having already had a herniated disc.

Variant

hanging leg raises variant

By raising your knees on the side alternately to the right and to the left, obliques work more intensely.

Abdominal lumbar balance

It’s necessary to work in a balanced way the abdominal’s muscles and the back’s muscles (erector spinae). A lack of tone of hypertonicity of one of these two muscle groups can create a bad posture, and over time, create pathologies.

Example

Hypertonicity of the lower part of the erector spinae (sacro lumbar mass) with a hypotonicity of the muscles of the abdomen, will create a hyperlordosis with an abdominal ptosis. This postural defect can sometimes (if it is taken in time) be diminished by exercises of reinforcement of the abdominal muscles.

Conversely, hypertonicity of the abdominal muscles with loosening (hypotonicity) of the erectors spinae, especially in the upper part (multifidus spinae, longissimus, iliocostalis), will create a kyphosis (rounding back ) with loss of lumbar vertebral arch. This postural defect can sometimes (if it taken in time) be diminished by exercises of reinforcement of erectors spinae muscles.

Hypertonicity erector spinae muscles lumbar vertebral arch Hypotonicity abdominal ptosis

Kyphosis Hypotonicity erector spinae muscles lumbar vertebral arch Hypertonicity abdomen

Subscribe to my newsletter and share this article if you think it can help someone you know. Thank you.

-Steph