- CONDITION - Shoulder Instability
CONDITION - Shoulder Instability
Shoulder instability can be classified into two different types, dislocations and subluxations.
- Dislocations—This happens when the head of the humerus completely pops out of the socket. The first few times this happens, it is usually with significant trauma (although some people can have these without any injury at all). After that, it can get easier and easier for the joint to dislocate. Most shoulder dislocations are anterior. This means that the ball pops out the front of the socket.
- Subluxations —This is the feeling that the shoulder slips slightly out of socket, then immediately comes back in place. This often happens without any major trauma. Sometimes it happens in people who are very "loose-jointed". Sometimes these happen in just one direction (like out the front, or anterior), and other times they happen out multiple directions (e.g., front, anterior and back, posterior). This is called "multidirectional instability".
Most often, a diagnosis of recurrent shoulder dislocations can be made by simply listening to the patient's symptoms. These patients will come in stating that their shoulder pops out of socket, and either goes back in by itself, or has to be put back in by someone else. Sometimes, the tricky part is knowing which way the shoulder is coming out of the socket. It can come out the front ("anterior") or the back ("posterior") or both ("multidirectional"). Your doctor will usually order x-rays, and sometimes an MRI, to get a better idea of what is causing your dislocations (e.g., a torn cartilage, loose ligaments, etc.).
Diagnosing subluxations can be more tricky. There are physical examination maneuvers that your doctor can perform to get a better idea if your shoulder is loose. Sometimes, however, it is not always clear; people with subluxations may not know their shoulder is subluxating, they may simply experience pain. An MRI can occasionally be helpful in this diagnosis.
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