The shoulder’s anatomy, or it’s bony make-up, means that there is little to no structural stability provided by the bones themselves. There is a very small and flat socket that houses quite a large ball – meaning that the shoulder is prone to being unstable.
What stops the shoulder popping out is an intricate arrangements of ligaments and cartilage that tries to deepen the socket and provide more stability.
The reason shoulders pop out can be due to:
- Trauma where the supporting structures of the shoulder are damaged
- Repetitive micro-trauma over time associated with activities such as throwing
- A genetic pre-disposition to having unstable shoulders
With trauma, or repeated micro-trauma, these ligaments and cartilage can be stretched or damaged – the most common problem is what is known as a Labral Tear of the shoulder. A Labral Tear occurs when the small ring of cartilage that surrounds the edge of the socket is torn away and allows the ball to move forwards and out of the socket.
This can result in subluxation (where the ball moves partially out and then back in) or dislocation (where the ball falls completely out of the socket).
The way that we treat this conservatively is to try and strengthen the muscles that surround the ball and socket joint, known as the rotator cuff.
We do this with a progression of exercises, starting with theraband exercises with the arm by the side, progressing to have the arm away from the body and eventually more advanced exercises that are dynamic and put more load on the shoulder.
We also work on making sure the shoulder blade, or scapula, stays in a stable position – as the shoulder blade is the socket of the shoulder joint and we need to ensure that this is working efficiently as well. This can be done with a series of exercises that work firstly on the pattern of the muscles around the shoulder blade, and then the strength and control of these muscles in a weight-bearing position.
Finally, the other conservative option for treating shoulder instability is taping. For contact sports this will be in the form of a combination of rigid and elastic strapping that prevents the arm going into the “stop sign” position which is the position of instability in the shoulder.
For throwing sports, the use of kinesio-taping may provide sufficient feedback to the muscles around the shoulder to help them stabilise the joint, whilst still allowing full range of motion in the shoulder.
So, there is plenty of treatment options for a shoulder that feels like it’s popping out. If you’re showing signs of shoulder instability, at Leading Edge we would be pleased to take you through a comprehensive and individualised rehabilitation program that will get you back into action as soon as possible. Simply click HERE book an appointment with one of our physios and get you back in the game.