Episode 1947 - Why the unstable shoulder feels chaos
Apr 1, 2025
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Delve into the complexities of unstable shoulders and their chaotic presentations. Explore the three main types: stiff, weak, and mobile shoulders, with a focus on the unique challenges of mobile cases. Discover vital clinical indicators for assessment, like pain at end ranges and glenohumeral joint motion. Gain insights on therapeutic strategies that empower patients and shift away from traditional methods. The discussion ends with practical rehabilitation suggestions to enhance patient care.
Understanding the specific clinical signs of a mobile shoulder, such as pain and excessive motion, is vital for effective treatment.
Focusing on restoring patient confidence through innovative exercises can enhance recovery in patients with unstable shoulders.
Deep dives
Understanding the Mobile Shoulder
A mobile shoulder often presents with specific clinical signs, such as pain at end ranges, excessive glenohumeral joint motion, and weakness in certain positions. These symptoms typically stem from a history of trauma like dislocation or subluxation, often seen in athletes involved in overhead activities. Common injuries include bankart or slap lesions, which result from excessive movement and can lead to significant psychological considerations in patients. Recognizing these signs is critical for developing effective treatment plans that address both the physical and emotional aspects of recovery.
Effective Treatment Strategies
Treatment for individuals with a mobile shoulder should focus on restoring confidence and autonomy rather than merely increasing range of motion. It is essential to avoid traditional approaches like stretching and instead utilize soft tissue work and eccentric control exercises to help mitigate symptoms and empower patients. For example, exercises such as eccentric loading for the lats or posterior cuff can effectively build strength and stability without compromising patient autonomy. Therapeutic activities should engage the entire body, integrating both closed and open chain movements to enhance joint centration and overall control.
Incorporating Practical Rehab Protocols
A comprehensive rehab protocol for mobile shoulder patients includes a mix of unstable loading and closed chain exercises to enhance joint safety and confidence. Activities like downward dog taps, earthquake bar lifts, and eccentric kettlebell overhead presses can effectively develop strength and range of motion while mitigating pain. A structured 12-minute EMOM (Every Minute on the Minute) routine can be provided, emphasizing engagement in functional movements without stretching. Such targeted exercises can facilitate both physical recovery and psychological resilience, making them crucial for this patient demographic.
Dr. Lindsey Hughey // #ClinicalTuesday // www.ptonice.com In today's episode of the PT on ICE Daily Show, Extremity Division leader Lindsey Hughey discusses the complexities of the unstable shoulder, focusing specifically on the mobile shoulder presentation. Lindsey outlines the three main categories of shoulder conditions: stiff, weak, and mobile shoulders, while also acknowledging outlier cases such as central sensitization. She delves into the subjective and objective findings associated with mobile shoulders, including key clinical exam indicators like pain at end ranges and excess glenohumeral joint motion. Lindsey emphasizes the importance of correct treatment approaches for mobile shoulders and shares insights on how physical therapists can effectively manage these cases. The episode concludes with a rehab EMOM (Every Minute on the Minute) to consider for patient care. Tune in to enhance your understanding of mobile shoulders and improve your clinical practice!