If the shoulder is moved too far, tendons and ligaments tense up and prevent the shoulder joint from sliding/luxating. If the force applied to the joint from outside is greater than the force of the tendons and ligaments, the joint will slip out of place or overstretch. In the worst case, this can result in permanent shoulder instability. Shoulder instability can be determined by a doctor on the basis of the medical history and a physiological examination.
Physiotherapy/treatment
Physiotherapy plays a decisive role in the treatment of shoulder instabilities, both as a conventional method and as pre- or post-operative treatment. Due to the special structure of the shoulder joint, however, it is extremely important to take an exact anamnesis before starting treatment so that shoulder instability is not negatively promoted by the treatment in the worst case. In an intensive patient consultation, the therapist will therefore try to determine the exact problem at the beginning, taking into account the clinical results.
Through specific questions and a physiological examination, certain patterns in the type of shoulder instability can usually be identified, so that appropriate therapeutic measures can be individually tailored. The 3 most frequent causes or clinical patterns of shoulder instability are: TUBS = traumatic, undirectional (i.e. only in one direction), Bankart lesion, surgical: Here the cause of shoulder instability is an injury, for example a fall while skiing or an injury during a throwing movement. During treatment, it is important that the patient learns to adapt his movements so that old patterns do not cause a new injury.
AMBRI = atraumatic, multidirectional (in all directions), bilateral (on two sides), rehabilitation and inferior (lower part of the capsule): Here the cause of the complaints is not based on trauma. The problems are usually ambiguous, which is largely due to a very stretchable connective tissue. Through specific exercises and a slowly increased training, an attempt is made to stabilize the insufficient connective tissue.
FI = functional instability: in this form of shoulder instability, the problems are usually caused by muscular imbalances. In the physiotherapeutic treatment of this pattern, it is important to train the entire chain of movement of the shoulder joint. In general, atraumatic problem causes have a greater chance of complete rehabilitation than traumatic ones.
The discipline and cooperation of the patient is decisive for the success of the therapy.
- TUBS = traumatic, undirectional (i.e. only in one direction), Bankart lesion, surgical (operative): Here, the cause of shoulder instability stems from an injury, for example a fall while skiing or an injury during a throwing movement. During treatment, it is important that the patient learns to adapt his movements so that old patterns do not cause a new injury.
- AMBRI = atraumatic, multidirectional (in all directions), bilateral (on two sides), rehabilitation and inferior (lower capsule section): Here, the cause of the complaints is not based on trauma.
The problems are usually ambiguous, which is largely due to a very stretchable connective tissue. Through specific exercises and a slowly increased training, an attempt is made to stabilize the insufficient connective tissue.
- FI = functional instability: in this form of shoulder instability, the problems are usually caused by muscular imbalances. In the physiotherapeutic treatment of this pattern, it is important to train the entire chain of movement of the shoulder joint.
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