Shoulder instability is a disorder that mostly comes up in relation to very active persons, professional sportsmen, and those who have to perform repeated overhead movements in their jobs. The case study presented here takes a deep dive into a real-life situation involving a patient from Abbotsford, BC and also collects the views of experts on how to make a diagnosis, find suitable treatment, and manage the condition in the long run via physiotherapy.
Patient Background
A 29-year-old male, recreational volleyball player, traveled to our Physiotherapy Abbotsford clinic and reported that he had experienced repeated “popping out” sensations in his right shoulder during the last half-year. These instances were commonly caused by overhead spikes or rapid arm movements.
Clinical Assessment
To start with the assessment, the patient showed the following symptoms:
– Positive apprehension and relocation tests – Generalized ligament laxity – Reduced proprioception in the glenohumeral joint
Noted strength insufficiencies were in rotator cuff muscles, mainly infraspinatus and subscapularis. Range of motion (ROM) was within normal range.
Diagnosis
By physical examination and previous imaging (MRI showing a Bankart lesion) the diagnosis was made that the patient had anterior shoulder instability caused by repetitive microtrauma.
Treatment Plan: A Physiotherapy Approach
In our Physiotherapy Abbotsford clinic, we implemented a personalized rehabilitation protocol spanning over 12 weeks which concentrated on the following:
Phase 1:
– Ice therapy and taping
– Isometric strengthening exercises
– Education on activity modification
Phase 2:
– Theraband resisted rotations
– Closed-chain kinetic exercises
– Neuromuscular control drills
Phase 3:
– Plyometric drills
– Sport-specific tasks (e.g., spike simulation)
– Dynamic stability exercises
Phase 4:
– On-court performance assessment
– Gradual return to training with team
– Injury prevention education
Real-World Challenges
During the first few weeks, the patient could not stop himself from doing overhead activities which unfortunately caused minor setbacks. In response, we not only replaced such activities with other cardiovascular exercises like cycling but also engaged in logging progress charts for frequent motivation.
Outcome
After 12 weeks, the patient displayed:
– 90% improvement in shoulder stability
– Full return to recreational Volleyball
– No further dislocation in 6 months post rehabilitation
Expert Tips for Managing Shoulder Instability
- Start Early: Address instability symptoms before they exacerbate into a chronic state of dislocations.
- Prioritize Scapular Control: The onset of shoulder issues often originate with poor scapular mechanics.
- Balance Mobility with Stability: Excessive stretching is likely to exacerbate laxity—strength is important.
- Functional Progression is Vital: Do not jump back into sport specific activities without proceeding from the foundational strength phase.
- Trust the Process: Rehabilitation can be frustrating—set attainable goals, follow the plan.
Frequently Asked Questions (FAQs)
- What can lead to shoulder instability in people who are active?
Shoulder instability can be due to an overload of the shoulder joint through repetitive overhead activities, a sudden traumatic injury, and/or hypermobility. All varieties of active individuals experience shoulder instability and athletes in particular become notable for developing shoulder instability. At Physiotherapy Abbotsford we examine movement patterns and determine the root cause of the instability, whereupon we can create a personalized assessment and treatment plan.
- How does a physiotherapist diagnose shoulder instability?
We rely on clinical assessments here at Physiotherapy Abbotsford, which are then followed up with other objective tests like the apprehension test, relocation test, glenohumeral range of motion and even imaging like an MRI (if necessary) to rule out any labral tears or ligament damage.
- Is physiotherapy enough for shoulder instability, or do I need surgery?
Most cases are successfully managed without surgical intervention, particularly if they are caught early. At Physiotherapy Abbotsford, we see a broad variety of shoulder injuries and focus strongly on facilitating proper strength, neuromuscular control and stability to help the patient avoid surgery altogether.
- How long does it take for an unstable shoulder to recover from physiotherapy?
When you participate consistently in physiotherapy, the duration to return to function can take 8-12 weeks. The physiotherapy clinic at our centre in Abbotsford has structured programs that are modified based on individual progress, while also helping to ensure long-term recovery and safe return to activity.
- What exercises are used to strengthen an unstable shoulder?
Specific exercises include isometric contraction holds, rotary resistance band holds, scapular stabilization drills, or retraining functional movement. Each of these fall under shoulder rehabilitation protocols at Physiotherapy Abbotsford.
Final Thoughts
Shoulder instability can happen to anyone, and does not have to dictate your lifestyle or performance. A physiotherapy program which is organized and designed efficiently can lead to full recovery, and this is undoubtedly possible.
If you have similar symptoms and want to see all of this managed effectively, visit our Physiotherapy Abbotsford clinic. We have a team of highly skilled practitioners that are experts in industry specific sports injuries, postural corrections, and personalized rehab programs.