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Shoulder instability

When talking about unstable shoulder, different nosologic schemes are to be taken into consideration, such as dislocations, subdislocations and the pathology of iper-laxation.

Various classifications have been proposed, but we will refer to that instability that involves patients with signs of congenital generalised laxity, associated with bilateral and multidirectional (anterior, posterior and inferior) instability of the shoulder.

The instability can also affect sportspeople such as gymnasts, volleyball players, weightlifters and swimmers. 
The traumatic mechanism is to be found in the repetition of overhead movements that, due to the joint laxity, provoke anomalous mechanic stimulus on the nervous structures and periarticular soft tissues (repeated microtraumas) that lead to pain.

If you entered this section, it means that you probably are starting feeling pain in your shoulder or that you are suffering from disturbances such as “dead arm” or paresthesia of the superior limb when performing daily or sportive activities. You might also have faced different times a dislocation or subdislocation without a meaningful trauma.

The physichian will prescribe for you further examinations to detect which are the conditions of capsular, tendinous, muscular  and annulet structures.
The conservative treatment represents the first approach to the management of this complex clinic situation. The work is mainly finalised to improving the joint biomechanics though exercises for those muscles that stabilise the articulation.
In particular, in the overhead sports it is necessary to reinforce all the cuff’s muscles, since they are involved in the control of the humeral translation. The recovery of the neuromuscular control is essential, as the deficit in co-ordination for these patients is typical. Co-ordination exercises can find a proper space in rehabilitation on the field, where the patient will undergo dynamic and more specific exercises.

After the failure of at least 6 month of conservative therapy, a surgical intervention will be necessary and an appropriate rehabilitative treatment will follow.

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