There are two joints at the shoulder, the GH joint (Glenohumeral) and the AC joint (Acromioclavicular). The GH joint is the main mobile shoulder joint. It is actually the most mobile joint in the body. As a result of such high levels of mobility, some of its biggest problems come from instability. This joint gains some stability from the labrum holding the humeral head into the glenoid fossa of the scapula and some ligaments supporting it. However, most of its stability comes from a group of muscles called the rotator cuff. Rotator Cuff injuries can affect the ability of these muscles to provide stability to the shoulder joint. Tears to the labrum, known as labral tears or other ligament sprains can also affect the integrity and stability of the shoulder.
The AC joint, in contrast offers very little movement. This joint is between the collarbone (clavicle) and a bony prominence on the shoulder blade (spine of the scapula) and is held together by numerous ligaments. It can become injured and lose its stability when the AC joint is separated by a fall on an outstretched hand or a blow to the shoulder, generally from the side. In either of these cases, damage can occur to the ligaments that hold the joint together causing an AC joint or ligament sprain. The result is a very unstable joint that in extreme cases can result in the visible separation of the bones or bump on the tip of the shoulder, called a step deformity.
In any case of shoulder instability, your Physiotherapist or Athletic Therapist will do a thorough assessment to determine which structures may be damaged or injured and where the instability lies as well as any causes that will be necessary to treat. They can then provide the manual therapy needed to help progress healing and improve functional mobility and posture. They will address all tensions and weaknesses with exercises to target these areas as well as address overall shoulder proprioception, balance and stability.
Registered Massage Therapy may be able to help in cases of shoulder instability in their ability to help loosen tensions and adhesions and get any swelling moving towards the lymph nodes to be removed from the body.
As with all injuries, this information is simply a guide, and it is always best to check in with a Physiotherapist or Athletic Therapist to have a personalized assessment and hear recommendations for what you and your body may specifically need.
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