1. This is the shoulder joint, including the humeral head and glenoid.
2. This shows a dislocated shoulder, which occurs when the ball (humeral head) falls out of the socket (glenoid).
3. Swimmers are overhead athletes, which makes them at risk for shoulder instability.
The shoulder is a ball and socket joint, with the humeral head as the ball and the glenoid as the socket. Instability occurs when the ball slips out of the socket, through dislocations or partial dislocations (subluxation). Because the shoulder has such a great range of motion, it can even experience instability in multiple directions (anteriorly, posteriorly, and in multiple directions).
A variety of tissues keep the shoulder in place, including a capsule, labrum, ligaments, tendons, and muscles. An injury to any of these structures can contribute to shoulder instability. A previous dislocation can also lead to shoulder instability, because the tissues of the shoulder can be damaged in the process.
In addition to a previous dislocation, labral tears, genetics, repetitive strain, and multidirectional instability can lead to shoulder instability. Repetitive strain can make the ligaments holding the shoulder in place more loose, making it more difficult to maintain shoulder stability.
At-risk populations for shoulder instability include individuals with very loose joints or connective tissue issues, as well as overhead athletes (like baseball, swimming, and volleyball).
If you are experiencing shoulder instability, you may feel like the ball is falling out of its socket. You may also experience bruising, swelling, a reduced range of motion at the joint, and even a feeling of tingling and numbness radiating down the arm. Additionally you may feel a cracking or popping sensation when moving the joint, which is called crepitus.
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Shoulder instability is typically diagnosed through a physician taking a history and physical examination. Diagnostic imaging tests like X-Rays, MRIs, and CT scans can also help diagnose this condition.
The initial treatment for shoulder instability includes rest, ice, NSAIDs, avoiding aggravating activities, and immobilizing the joint via a sling or brace. After this, physical therapy exercises to increase strength and range of motion in the shoulder can help increase stability.
If these options are unsuccessful, surgery can be performed via arthroscopy, or open surgery (in more severe cases).
Attribution for Images
1. OpenStax College. “Shoulder Joint”. Wikimedia Commons, 19 May 2013, https://commons.wikimedia.org/wiki/File:914_Shoulder_Joint.jpg.