SPORTS INJURIES
Chronic Shoulder Instability
A natural consequence of weakened or injured shoulder ligaments is
chronic shoulder instability. This situation may occur as a
result of previous shoulder dislocations, but may also occur
due to congenitally loose joints or from repetitive pitching,
throwing, or serving. Repetitive microtrauma, occurring as
a direct result of these injuries, begins to take its toll
on the supporting structures of the shoulder and disrupts the
delicate balance between mobility and stability. At one extreme,
a football player may have such profound instability of the
shoulder that he may repeatedly dislocate the shoulder throughout
the season and even be able to pop it back into place by himself.
This is a bad situation because, not only is he repeatedly
traumatizing his shoulder and compromising function, but he
is also setting himself up for arthritis in the years to come.
At the other extreme is a tennis player who has served for
many years, or a professional baseball player who has been
pitching since Little League. This type of individual may not
progress to an actual dislocation, but subtle signs of joint
instability and laxity are evident, including pain with abduction
and external rotation (called a Positive Apprehension Test),
tenderness to palpation throughout the shoulder joint, and
the subjective feeling of weakness in the arm (Dead Arm Syndrome).
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