There are 3 basic types of shoulder instability. These include anterior, posterior, and then there is multidirectional instability. Let’s review in this article Anterior Shoulder Instability.
Anterior instability involves an issue where the shoulder will potentially dislocate out the front. This dislocation or just instability can occur because of repetitive overhead throwing or trauma like a car accident. If a pitcher throws a lot continuously and repetitively it may lead to a slow, gradual soft tissue elongation in the front of the shoulder. As this gets worse, the humeral head may start to displace from the glenoid (the ball coming out of the socket), especially if the rotator cuff muscles get fatigued. It would be unusual to frankly dislocate as a result of this chronic situation without some additional trauma like an athletic collision or fall. The end result of this could be if an athlete is involved in a collision or trauma then a Bankart lesion may take place and one may need orthopedic surgeons phoenix az to surgically repair it. In an overhead thrower such as a pitcher in baseball who is suffering from instability of the anterior type, there’s often symptoms of feelings of looseness of the shoulder when the arm is in the cocked position of throwing. Rather than having frank instability, the pitcher will typically note severe and sudden pain with arm control loss. In addtion, the athlete can experience arm tingling or possibly a dead arm feeling. There are a few different types of physical examination tests to evaluate for anterior instability, which are performed in a controlled setting by a sports medicine doctor to prevent actual dislocation (thankfully). Treatment for anterior instability is treated by Phoenix orthopedic surgeons depending on the instability severity. If the athlete has a lax shoulder from repetitive trauma such as throwing a baseball 95 miles an hour twice a week in games, Phoenix physical therapy can be attempted which will work on strengthening the rotator cuff muscles to prevent the instability and pain. As the therapy moves along, the athlete can start sports participation as long as a successful throwing program is completed with emphasis on proper mechanics. In those who have a traumatic history of anterior instability such as a car accident, there is often a Bankart lesion. This is a situation that occurs after a dislocated shoulder that comes out the front part. As the humeral head dislocates out the front, the glenoid labrum (shoulder cartilage) is damaged and there could also be some bony injury too. This is damage to the ball and socket part of the joint. The labrum is a cartilaginous part that forms a cup where the humorous moves. This allows for stability of the shoulder and a large range of motion. When a shoulder dislocation damages the shoulder, it often does not heal by itself. The actual portion of the labrum which experiences damage is called the inferior glenohumeral ligament. After a patient has sustained a traumatic dislocation with a Bankart lesion, symptoms that the individual may feel include a catching sensations, sense of instability, aching of the shoulder, or unfortunately repeat dislocations. Along with this, the person often says that they simply cannot “trust” their shoulder because they think it may dislocate at any time. When an individual sustains a shoulder dislocation with a labral injury, statistically the chances of re-dislocating are over eightly percent if the person is younger than thirty years. This grows a lot if the person is over age thirty. Along with the physical exam tests looking at shoulder instability, the best test to look at this injury is an MRI. The orthopedic surgeon Phoenix AZ may order the test with contrast injection which may allow better visualization of the injury. Surgery is only for for those individuals who fail considerable nonoperative treatment or who potentially have a history of traumatic shoulder dislocation. In the vast majority of patients no true indication exists to have immediate surgery for this injury type. However, if the injury is a high-level athlete who wants to get back for the next season as a professional, they will need to understand that healing from a labrum repair can take six months or even more. Contemporary arthroscopic shoulder surgery involves reattaching the labrum to the shoulder’s socket. Successful outcomes have been reported in about ninety percent of athletes who are overhead throwing athletes. When it comes to returning to full competition though, the percent of success drop down to 68%.
FXRX is the premier practice of orthopedic surgeons Phoenix AZ in the state and also has Orthopedic Surgeons Mesa AZ. FXRX has Sumit Dewanjee MD who is a Board Certified, Fellowship Trained Sports Medicine surgeon. Call (480) 449-3979 to make your appointment TODAY!