Sports Injuries: Kin 3K03
GLENOHUMERAL INSTABILITY (GHI)
GH Joint Stabilizers
o Things that hold the joint together: joint capsule, ligaments (reinforce the capsule; mostly
anterior and inferior aspects of joint), labrum (functions as suction cup to hold joint together),
negative intrajoint pressure (suction mechanism brings 2 bones together)
o SITS muscles responsible for holding humeral head to glenoid fossa (supraspinatus,
infraspinatus, teres minor, subscapularis)
What Is Instability?
- Instability leads to subluxation and complete dislocation
o Trauma; unstable shoulder related to trauma
o Unidirectional instability; injured in one direction
o Bankart lesion; detachment of labrum off glenoid
o Surgery; required
o Atraumatic; minor trauma
o Multidirectional instability; more than one direction
o Bilateral; not specific to one shoulder. AMBRI people have generally loose shoulders from birth.
o Rehabilitation; treatment of choice
o Inferior capsular shift; preferred surgery
• FEDS Kuhn
o Frequency; how often do they experience instability?
o Etiology; how did it happen? trauma or no
o Direction; which way is the dislocation?
o Severity; did the shoulder go back in on its own or did you need assistance?
• Common mechanism: abduction (close to 90 deg.), lateral rotation, axial (traumatic) load to the
shoulder from behind pushing it forward.
• Appearance: prominence of humeral head (with someone with less muscle), deltoid contour - you will
see: bulge in armpit, fossa, acromion, but not deltoid. Patient will be holding their arm close to their
• Symptoms: PAIN (lots of it)
• Axillary nerve damage? Armpit nerve, sensory and motor disruption with anterior dislocation. Where will
they have sensory disruption and what muscles will be affected? (independent study)
o Deltoid will be affected and sensory loss will occur below the shoulder around deltoid
- Bankart Lesion:detachment of glenoid labrum from glenoid (80% of people who have their first
dislocations will have this). When a labrum/lip is damaged, you will have dislocations frequently.
- SLAP Lesion: superior labrum from anterior to posterior. T