Nonoperative and postoperative rehabilitation for glenohumeral instability

Clin Sports Med. 2013 Oct;32(4):865-914. doi: 10.1016/j.csm.2013.07.017.

Abstract

The glenohumeral joint is an inherently unstable joint that relies on the interaction of the dynamic and static stabilizers to maintain stability. Disruption of this interplay or poor development of any of these factors may result in instability, pain, and a loss of function. Rehabilitation will vary based on the type of instability present and the key principles described. Whether a course of nonoperative rehabilitation is followed or the patient presents postoperatively, a comprehensive program designed to establish full ROM and balance capsular mobility, in addition to maximizing muscular strength, endurance, proprioception, dynamic stability, and neuromuscular control is essential. A functional approach to rehabilitation using movement patterns and sport-specific positions along with an interval sport program will allow a gradual return to athletics. The focus of the program should minimize the risk of recurrence and ensure that the patient can safely return to functional activities.

Keywords: Proprioception; Rehabilitation; Return to function; Shoulder instability.

Publication types

  • Review

MeSH terms

  • Athletic Injuries / physiopathology
  • Athletic Injuries / rehabilitation
  • Athletic Injuries / surgery
  • Exercise Therapy
  • Humans
  • Immobilization
  • Joint Instability / etiology
  • Joint Instability / physiopathology
  • Joint Instability / rehabilitation*
  • Joint Instability / surgery
  • Orthopedic Procedures / methods*
  • Postoperative Care / methods*
  • Practice Guidelines as Topic
  • Range of Motion, Articular
  • Recovery of Function
  • Shoulder Dislocation / etiology
  • Shoulder Dislocation / physiopathology
  • Shoulder Dislocation / rehabilitation*
  • Shoulder Dislocation / surgery
  • Shoulder Joint* / injuries
  • Shoulder Joint* / physiopathology
  • Shoulder Joint* / surgery