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Strengthening exercises are recommended for instability of shoulders


Clear guidelines will help medical professionals give the best available treatments


Glenohumeral instability—or shoulder instability—is a condition that occurs when the head of the upper arm bone (humerus) falls out of the shoulder "socket," which is called the glenoid. It affects approximately 2% of the general population and can either happen due to an injury or develop gradually over the course of time. The shoulder is the most mobile but least stable joint in the body, which is one of the major reasons this condition occurs. Athletes who engage in activities that involve overhead motions like baseball, swimming, volleyball, football, tennis and weight lifting repeatedly place stress on the shoulder and increase their chances of developing shoulder instability. Patients with shoulder instability generally experience pain and weakness in the front and back of the shoulder joint, as well as a possible tightening and/or clicking sensation in the back of the shoulder. Several treatments are available for addressing shoulder instability, but there is a need for clear guidelines to better assist medical professionals making treatment decisions. For this reason, a powerful study called a systematic review was conducted, which collected all the highest-quality research available on the topic and compared their findings with the goal of establishing a connection between them.


Three medical databases searched for appropriate studies


Investigators conducted a search of three major medical databases to find relevant studies on different types of rehabilitation programs for shoulder instability. This search led to 101 studies being identified and assessed, and of these, only five met the necessary criteria and were used for the review. Each of these five studies was evaluated to determine its level of quality and then analyzed to find similarities between their findings.


Strengthening of several muscles around the shoulder appears best for condition


Results of this review found strengthening exercises for the rotator cuff and deltoid muscles were most effective for treating shoulder instability by reducing pain and instability, as well as increasing function. A rotator cuff is a group of tendons and muscles that surround the shoulder and keep it stable, and the deltoid is a rounded muscle located on the top of the shoulder. Another component of treatment that was found to be beneficial was scapular stabilization exercises, which are another form of strengthening exercises that target the shoulder blade (scapula) and help keep it stable during movement. Based on these findings, researchers recommend a rehabilitation program that focuses on rotator cuff and deltoid strengthening exercises, and they believe that performing scapular stabilization exercises beforehand may lead to even better results. Medical professionals should take note of these findings, and individuals dealing with shoulder instability to any degree should view physical therapy with strengthening exercises as a strong option to address their condition and help them improve.


-As reported in the November '16 issue of Physical Therapy in Sport
January 18, 2018