Among all joints present in the human body, the shoulder joint has the widest motion range. This allows a greater scale of flexibility when lifting and revolving your arm in a variety of directions, this wider motion range however also translates to less stability.
Shoulder instability tends to occur when the upper arm bone, the humerus is forcefully pushed out of the glenoid, the socket of the shoulder. This could be as a result of severe trauma for example due to overuse or a sudden injury.
Once a shoulder dislocation occurs, it gets more vulnerable to recurrent episodes. If the shoulder loosens and keeps slipping out of place repetitively, it is known as chronic shoulder instability.
Anatomy
The joint of the shoulder consists of three main bones: the humerus or upper arm bone, the scapula also called the shoulder blade and the clavicle also known as the collarbone. The head of the bone of your upper arm, the humerus fits well into the glenoid which is a shallow socket in your scapula or rather the shoulder blade.
The strong connective tissue of the shoulder capsule in combination with the stabilizing ligaments of the shoulder keep the head of the upper arm bone centered in the glenoid socket. The strong tendons and muscles surrounding the shoulder such as the rotator cuff also help provide shoulder stability.
Once the ligaments, tendons, and muscles around the shoulder become loose or torn, dislocations can occur repeatedly. Chronic shoulder instability is the persistent inability of these tissues to keep the arm centered in the shoulder socket.
Cause of Shoulder Instability
Severe trauma or injury is usually the source of a preliminary dislocation. Once the head of the humerus is dislocated, the glenoid (socket bone) and the ligaments in the anterior of the shoulder are regularly injured. The ligament that is torn in the shoulder’s anterior end is normally known as a Bankart lesion. A very severe first dislocation could lead to a series of dislocations, therefore causing instability.
Some individuals with shoulder instability have actually never experienced a dislocation. Most of the affected patients have some looser ligaments present in their shoulders. Sports such as volleyball, tennis and swimming involve repetitive motion over the head and that can nicely stretch out the ligaments of the shoulder. A lot of jobs also need repetitive movement overhead. Loosened ligaments can harden the maintenance of the stability of the shoulder. Repetitive and stressful actions can end up challenging a shoulder that has weakened leading to a painful and unsteady shoulder.
Conservative Treatment
Dr. Samimi will come up with a specific treatment procedure that will get rid of your symptoms. Non-surgical treatment procedure usually include alterations in your lifestyle so as to avoid actions that worsen your symptoms and non-steroidal anti-inflammatory medicine. Most importantly, there is physical therapy that strengthens the muscles of the shoulder.
Surgical Treatment
Once conventional treatments and the physical therapies are unable to get rid of the pain and unsteadiness, your orthopedic surgeon may vouch for chronic shoulder instability surgery.
Dr. Samimi is specialized in use of marginally invasive surgery known as the arthroscopic surgery that repairs torn or stretched out ligaments to enable them to hold the joint of the shoulder in position. Bankart lesions can be treated surgically with stitches and anchors to re-attach the ligament to the bone and then re-tighten the capsule of the shoulder.
What happens during the procedure?
The shoulder arthroscopy surgical practice is used in the visualization, analysis, and treatment of complications in a joint. It consist of making of a tiny incision in the skin and then placing in a pencil-sized arthroscope into the joint with the injury or damage. The small camera and instrumentation of the arthroscope permit Dr. Samimi to see the inside of the joint in an enlarged and well-lit mode to diagnose the amount and form of the ligament tear and repair it precisely.
After the surgery, all the incisions are stitched and then dressed. The patients normally return home the same day covered in a sling and a course of physical therapy follows. Two days after surgical procedure, the bandage is removed and showering is permitted. The tiny incisions are covered using a band-aid.
Dr. Samimi takes pictures in the course of the practice from the video monitor in order to show you whatever was found and also what took place. He feels there is importance in you understanding the nature of the complication and precisely what was done to resolve it.
Arthroscopy is more or less always done as an outpatient surgery. The benefits include reduced risk, smaller amount of complications, reduced post-operative pain, less recovery time and greatly reduced scarring. With this negligibly invasive process we treat shoulder instability with tremendous results.
