Glenohumeral Instability

glenohumeral instability— AMBRI & TUBS

instability of the shoulder/your glenohumeral joint; frequent impingement or dislocations

• AMBRI— “Always been loose”, meaning slow onset or congenital (always has been there or has slowly developed)

  • Atraumatic

  • Multidirectional instability

  • Bilateral

  • Rehabilitation

  • Inferior shift

• TUBS— “Torn loose” or “Traumatic”

  • Traumatic

  • Unidirectionality instability

  • Bankart lesion

  • Surgery required

GH instability— AMBRI shoulder

no history of dislocation; just impingement present (i.e., the head of the humerus moves too much in the joint), especially with overhead motions like throwing (i.e., humeral head rolls upward instead of staying in place)

• RTC muscles don’t properly counteract the upward pull of the deltoid, resulting in impingement

  • usually 2/2 RTC weakness or poor proprioception

• typically non-surgical treatment

GH instability— TUBS shoulder

history of dislocation (usually anterior)

• Bankart lesion= damage to anterior and inferior portion of GH capsule, allowing for repeated dislocation

• SLAP lesion= superior labrum anterior to posterior

• typically surgical treatment (after non-surgical attempted)

treatment

focus: strengthen and improving RTC and scapular muscles

• start with isometrics in neutral position

• anterior instability: focus on internal rotators and adductors

• global instability: all muscles of the shoulder and scapula