Multidirectional Instability of the Shoulder: Treatment Options and Considerations

Matthew J. Best, Miho Tanaka

Research output: Contribution to journalReview article

Abstract

Multidirectional instability (MDI) is a debilitating condition that involves chronic subluxation or dislocation of the shoulder in >1 direction. Numerous proposed mechanisms of MDI exist, which occurs in the setting of redundant capsular tissue. Symptoms can range from recurrent dislocations or subluxations to vague aching pain that disrupts activities of daily living. Magnetic resonance imaging is often performed during evaluation of this condition, although magnetic resonance arthrography may provide more detailed images of the patulous capsule. In the absence of a well-defined traumatic cause, such as a labral tear, initial treatment for MDI is a structured rehabilitation program with exercises aimed at strengthening the rotator cuff and periscapular muscles to improve scapular kinematics. Patients with recalcitrant symptoms may benefit from surgical stabilization, including open capsular shift or arthroscopic capsular plication, aimed at decreasing capsular volume and improving stability.

Original languageEnglish (US)
Pages (from-to)113-119
Number of pages7
JournalSports Medicine and Arthroscopy Review
Volume26
Issue number3
DOIs
StatePublished - Sep 1 2018

Keywords

  • arthroscopic capsular plication
  • glenohumeral joint
  • ligamentous laxity
  • multidirectional instability
  • open capsular shift
  • shoulder instability

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

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