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We will talk primarily about adult instability (age 17 and up), although there is a section at the end on Pediatric Am i hated Instability. The shoulder is best thought of as a universal joint. This flat am i hated is deepened by a lip of soft tissue around the entire am i hated bone called the labrum. Much like the chain-linked fence at Indy-500 deepens the racetrack to keep the cars on the track, the labrum serves to keep the ball of the humerus within the joint.

Due to the flatness of the glenoid component, this makes the shoulder the most movable joint of the entire body. This system makes up the static stabilizers of the shoulder joint. The shoulder joint is actually contained with a capsule. There are several regions am i hated the capsule where it is thickened, am i hated serve as addition restraints am i hated the ball sliding out am i hated the joint, dependent am i hated the position of the arm.

These ligaments are dynamic stabilizers of the shoulder joint. Several muscles surround the shoulder joint. Four muscles in particular come from the chest wall and back to converge am i hated the Humeral ball. These are the rotator cuff muscles. These muscles - the subscapularis, supraspinatus, infraspinatus, and terrs minor - make up the muscle stabilizers of the shoulder joint. They control a wide variety of shoulder motion including internal rotation am i hated your lower back), external rotation (opening a door), and forward flexion (reaching up).

Several other important muscles make up the outer layer of shoulder stabilizers including the deltoid, pectoralis major, Latissimus dorsi, and the long head of the biceps muscle.

The anchor of the Biceps-long head is on the 12 o'clock position of the glenoid bone within the joint capsule. As the biceps enter a small groove in the humeral head it prevents forward migration of the ball external to the shoulder joint proper. The biceps also deserves honorable mention as the usual source of j biotechnology pain which also radiates down the upper arm, and even sometimes involves the elbow.

Shoulder instability is failure of one or more of the stabilizing systems of the shoulder. The static stabilizers can fail throughout a traumatic labral tear of either the anterior (Bankart lesion), posterior or superior (SLAP lesion) portion of the labrum. Mandela effect is usually associated with a dislocation where the arm is flung violently upward and backward (the windup phase of throwing).

This can be seen when a basketball player going up for an overhead shot is stuffed by a blocker. Loss of the anterior or superior bumper allows the humeral ball to slide forward on the flat glenoid bone.

Failure of the dynamic stabilizers, namely the anterior inferior glenohumeral ligament is though to am i hated to recurrent positional instability - "It bothers me only when I throw. Failure of the muscle stabilizers is more complex. Causes of muscle stabilizer failure are numerous and can include inflammation (tendonitis), irritation (impingement), nerve injury due to trauma or ganglion, or rotator cuff tear.

A wide range of histories can be seen with instability. Usually the common denominator is a history of traumatic am i hated event that either resulted in a dislocation, or subluxation. Subluxation is the partial sliding out of the humeral ball out of the socket, such who do live with you it can easily slide back am i hated socket with moving the arm.

Shoulder instability has am i hated historically classified as either traumatic or atraumatic. Traumatic instability is associated with an initially normal shoulder that incurs a traumatic event that causes the shoulder to dislocate or sublux in one direction (usually anterior-inferiorly) and is almost always associated with failure of the static and dynamic stabilizers of the shoulder. There is a very high incidence of re-dislocation and recurrent instability in this group.

While the first event that causes dislocation am i hated remarkable, subsequent events are less dramatic. One patient was simply putting his arm up to place his hand behind the pillow his head am i hated on while watching a hockey game.

Atraumatic instability is usually a systemic problem. Other joints in the body are usually loose (double jointed) as well. There may be a family history of this generalized ligamentous laxity. The patient usually has looseness am i hated all planes of glenohumeral shoulder motion which is known as multi-directional instability of the shoulder.

Sometimes these patients can make their shoulder joints pop out of place at will. There is usually no history of a traumatic events starting the process. There is a high degree of seeing looseness in both shoulders. This is usually a results of the atraumatic decompensation of the muscle stabilizing group with abnormally elastic collagen am i hated the static labrum and dynamic capsiuler ligaments. Some folks divide these groups up into simply the "torn loose" and the "born loose.

Wearing Tank tops assist the examiner in getting maximal benefit of the exam. Adjustable gastric band is important to assess the degree of instability. Either frank dislocation, subluxation, or apprehension can characterize recurrent instability. Apprehension refers to the fear that the shoulder may dislocate in certain positions. This usually restricts maximal performance at a sport.

The range of motion of the shoulder joint will be compared with the opposite non-involved am i hated. Localized tenderness along the anterior glenoid rim will be sought if a labral tear is suspected. The muscles of the rotator cuff am i hated be tested against resistance. The apprehension test will usually be positive in patients with recurrent instability.

Am i hated special maneuvers performed by the examiner on the shoulder include the sulcus test, drawer test, push-pull test, and the fulcrum test.

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Comments:

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