About Courses Library Newsletter Contact

Multidisciplinary Shoulder & Elbow Society Library

Our comprehensive library has everything you need to help you better understand your patients' shoulder or elbow problems.

Nonoperative Rehabilitation for Shoulder Instability

conservative management nonoperative physiotherapy rehabilitation shoulder instability treatment
Nonoperative Rehabilitation for Shoulder Instability

The goal of nonoperative rehabilitation for shoulder instability is to restore pain-free, normal motor control by employing tailored techniques applied appropriately and at the right time. Effective treatment relies on accurate clinical diagnosis, identification of structural abnormalities, and recognition of movement pattern issues to create personalized rehabilitation plans.

Overview: Shoulder stability is largely dependent on dynamic muscular control. Effective rehabilitation requires precise diagnosis, identification of structural issues, and addressing abnormal movement patterns. A multidisciplinary approach ensures sustainable outcomes.

Assessment: Diagnosis involves evaluating posture, core stability, scapular control, and muscle function, alongside structural and psychosocial factors. The Stanmore classification helps categorize instability types (traumatic, atraumatic, or muscle-pattern related), guiding treatment strategies.

Key Muscles: Shoulder stability is maintained by three groups:

  1. Scapular Muscles (e.g., trapezius, rhomboids, serratus anterior).
  2. Humeral Muscles (e.g., pectoralis major, latissimus dorsi).
  3. Rotator Cuff (RC) Muscles: Ensure joint stability through synchronized movement.

Rehabilitation Approach:

  • Early Stage: Focus on pain relief, restoring motor control, and addressing apprehension. Closed-chain exercises are recommended for co-contraction and proprioception.
  • Scapular Muscle Strengthening: Target specific imbalances, incorporating exercises like "push-up plus" for serratus anterior activation.
  • Rotator Cuff Training: Gradual strengthening through supported exercises, progressing to task-specific activities.

  • Adjunct Therapies: Techniques like kinesiology taping, biofeedback, and functional electrical stimulation enhance motor control, especially in patients with persistent dysfunction.

The goal is to restore pain-free, confident movement while minimizing recurrence through individualized and progressive rehabilitation.

Reference

Jaggi A, Alexander S. Rehabilitation for Shoulder Instability - Current Approaches. Open Orthop J. 2017 Aug 31;11:957-971. doi: 10.2174/1874325001711010957. PMID: 28979601; PMCID: PMC5611703.

Categories

All Categories ac joint dislocations ac joint separations acromioclavicular joint adhesive capsulitis advice anatomy antuna and seebauer classification arthroscopic subacromial decompression bursa capsule case of the week case study cervical spine cervicogenic pain charcot classification classification systems clinical pearls codman conservative continous learning continuing education corticosteroid cortisone cross-body adduction test cubital tunnel syndrome deltoid drop-arm sign dunning-krugger effect elbow elbow arthritis elbow arthroscopy elbow contractures elbow ct scan elbow imaging elbow osteoarthritis elbow pain elbow radiographs elbow septic arthritis elbow stability elbow stiffness elbow surgery elbow x-rays empty can epidemiology external rotation resistance flexor pronator strain force couple frozen shoulder full can glenohumeral joint glenohumeral joint osteoarthritis glenohumeral ligament glenoid bone loss hawkins-kennedy hemiarthroplasty historical definitions impingement infographic injection injury instability joint journal of shoulder and elbow surgery labral tears labrum lift-off test ligaments management muscles myofascial pain neck pain neer's sign neuropathic arthropathy neuropathy nonoperative normal shoulder orthopaedic special test orthopaedic special tests orthopaedics osteoarthritis osteomyelitis pain relief painful arc pathomechanics patient guide physiotherapy quiz question quiz question of the week radiculopathy range of motion rehabilitation revision surgery rotator cuff rotator cuff related pain rotator cuff tendinopathy scapular tilt scapulothoracic motion screw axes glenohumeral joint shoulder shoulder & elbow specialists shoulder arthritis shoulder dislocation shoulder instability shoulder motion shoulder osteoarthritis shoulder pain shoulder stability slap spurling test stability stable shoulder subacromial impingement subacromial pain syndrome subacromial space surgery synovial membrane the rockwood classification the unstable shoulder throwing injuries total shoulder arthroplasty trauma traumatic anterior shoulder dislocation treatment tubs ulnar collateral ligament injury ulnar nerve upper trapezius
FREE GIFT: SHOULDER CARE ALGORITHM INFOGRAPHIC

Join Our Newsletter & Get a FREE Membership

By signing up you for our newsletter you will get a FREE membership to the Multidisciplinary Shoulder & Elbow Society and we will send you our Shoulder Care Algorithm Infographic which was created and is used by our shoulder & elbow fellowship trained orthopaedic surgeons. On top of that you will receive our weekly newsletter which includes articles, educational resource, surgeon clinical pearls, along with access to instructional courses and the annual meeting.

You're safe with me. I'll never spam you or sell your contact info.