The shoulder joint is subject to a great deal of motion, more so than other large joints in the body. This makes the shoulder susceptible to dislocation. Anyone who has experienced a dislocated shoulder knows how painful it can be. In fact, a dislocation can lead to a condition called multidirectional instability of the shoulder (MDI). The joint dislocation can result in an excessive forward, backward or downward motion relative to its normal position. MDI is often seen as a result of a sports-related injury, but it can develop over time with repetitive use of the shoulder joint.

Surrounding soft tissues are also affected. Ligaments and muscles in the arm and shoulder region can become stretched or torn. At times, a genetic abnormality of the joint can be an underlying cause. Repetitive motions, shoulder sprains and sudden  muscle contractions can result in MDI. Individuals with below average fitness levels and 'loose joints' are also at risk.

Multidirectional instability leads to weakness in the rotator cuff muscles, which become fatigued and overworked. The surrounding bursa (fluid filled protective sacs), tendons and nerves may also get affected.

Pain in the shoulder at rest and with motion is a common symptom. MDI may be associated with numbness, paralysis and weakness in the shoulder. Some patients report a crackling feeling or sound in the shoulder area during motion.

Physical therapy plays a crucial role in recovery from any dislocation.

Your therapist will help position the shoulder joint in the right position and immobilize it to promote healing and prevent further damage. A sling may be used for three to eight weeks, depending upon the severity of the injury. Once healing is complete, physical therapy will facilitate recovery. Rehabilitation treatments can include:

Heat and Cold Therapy – Used to manage pain and reduce swelling.

Exercise – A customized program of gentle exercise to build stability, strength and muscle control helps offset muscle weakness after weeks in a sling. Patients will be provided with a strength and mobility program that can be implemented at home and work.

Clinical Pilates – At times, a specialized exercise program can be designed to regain muscle strength, tone, and control. Exercises may be performed with specialized equipment or independently.

Electrical Stimulation – The technique is used to improve muscle and ligament tone. This is a useful method to control pain and inflammation.

Water Therapy – Water relieves stress on joints and encourages patients to relax and move with relative ease. An aqueous environment provides support for weak muscles and joints and supports 'relearning' of muscle strength and control.

Multi-dimensional instability of the shoulder must be evaluated carefully to determine the best course of treatment. As your physical therapists, we will do everything possible to relieve your pain, prevent further damage, and provide the rehabilitation framework to help you recover quickly.

In fact, physical therapy can help with any pain or discomfort in any joint in the human body. If you or a loved one is experiencing stiffness, tingling or loss of joint function, give us a call. In particular, MDI is a complex condition, and it is often overlooked. The underlying cause for simple 'aches and pains' can be easy to ignore and lead to further pain and injury. Therefore, we encourage you to reach out to us as quickly as possible.

Once joint healing is complete, we put you through a routine of specialized exercises and therapies to help you regain strength, stability, and functionality. Give us a call to discover how physical therapy can help heal your shoulder and every joint in your body. We look forward to hearing from you!

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