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Shoulder Instability

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    Posted: Dec 13 2010 at 11:28pm
Hi,

Ive been diagnosed with instability in the shoulder and in the shoulder blade. Ive been to a physical therapist where she said I had extremely weak middle and lower trapezius and we worked on exercises for those (which would help me scapular stability). Ive been doing rotator cuff exercises also. Laxity is something that occurs on my left arm (fingers, elbow), and I am able to partially sublux my shoulder without any pain ("subtle reduction maneuver as ball goes back into joint", a phrase I heard in a youtube video).

With all this, I was wondering if all the exercising will actually make me not feel apprehensive when testing for shoulder instability (like a JOBE relocation test).

Ive been spending a lot of time searching online about my shoulder and it just occurred to me that maybe Im just not going to have the same range of motion or strength on my unstable left shoulder unless I opt for surgery. Is this the case for people with shoulder instability?

Also, whenever I do exercises for rotator or trapezius, it feels completely different from my right (strong) than my left (weak). Is this normal for those with instability?

So all in all, my main question is: will my left shoulder ever feel the same as my right shoulder again with proper exercising?    

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Post Options Post Options   Thanks (0) Thanks(0)   Quote labrum Quote  Post ReplyReply Direct Link To This Post Posted: Dec 14 2010 at 12:01am
I also wanted to add that my shoulder capsule is stretched out.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Ask a PT Quote  Post ReplyReply Direct Link To This Post Posted: Dec 15 2010 at 10:20am

How much laxity does your physical therapist or MD suspect that you have and with which direction(s) ie. anterior, posterior, inferior? I am assuming at least a grade II or III as you mentioned that you are able to sublux your shoulder partially and are able to reduce it back in place. With your instability, besides having a strength deficit, are you also experiencing pain when utilizing your shoulder? Ongoing shoulder pain despite participation in a rehab program would warrant further medical intervention(s).  

There are many factors at your shoulder joint which help contribute to its stability. They include the concave shape of the socket (glenoid fossa), muscular strength and compressive forces of the rotator cuff muscles & scapular stabilizers, the amount of restraint of the ligaments at the shoulder capsule and the thickness & integrity of the glenoid labrum. With participation in physical therapy and performing strengthening/stabililzation exercises, proprioceptive/somatosensory training & postural/functional training, it is possible to achieve min/none functional limitations for the patient with a grade I or II deficit. As far as shoulder instability tests, they should be performed slowly by the therapist, and I would assume given what you have described, that the testing will more than likely continue to yield positive findings for instability, despite strengthening/stabilization efforts.
 
As far as your question goes "will my left shoulder ever feel the same as my right shoulder again with proper exercising?", it would be difficult for me to determine without physically examining you. The more laxity and instability you have at your shoulder joint, the more likely surgical intervention may be required in order to help you achieve maximal functional outcomes. It would probably be best to ask this question to your therapist or orthopaedic MD who have physically examined you and will know your condition and will be familiar with your situation. Best of luck to you. 
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