Glenohumeral joint instability is extremely common yet the definition and classification of instability remains unclear. In order to find the best ways to treat instability, the condition must be clearly defined and classified. This is particularly important so that treatment studies can be compared or combined, which can only be done if the patient population under study is the same. The purpose of this paper was to review the problems with historical methods of defining and classifying instability and to introduce the FEDS system of classifying instability, which was developed to have content validity and found to have high interobserver and intraobserver agreement.

https://bjsm.bmj.com/content/bjsports/44/5/341.full.pdf

A new classification system for shoulder instability

Patellofemoral pain syndrome (PFPS) is one of the most common musculoskeletal disorders. However, no consensus on the definition, classification, assessment, diagnosis, or management has been reached. We evaluated symptoms and clinical findings in subgroups of individuals with PFPS, classified on the basis of the findings in radiological examinations and compared the findings with knee-healthy subjects. An orthopedic surgeon and a physical therapist consecutively examined 80 patients clinically diagnosed as having PFPS and referred for physical therapy. The examination consisted of taking a case history and clinical tests. Radiography revealed pathology in 15 patients, and scintigraphic examination revealed focal uptake in 2 patients indicating pathology (group C). Diffusely increased uptake was present in 29 patients (group B). In the remaining 29 patients radiographic and scintigraphic examinations were normal (group A). Knee-healthy controls (group D) reported no clinical symptoms. No symptom could be ...

Comparison of symptoms and clinical findings in subgroups of individuals with patellofemoral pain.

BackgroundObjective data quantifying differences in glenohumeral range of motion in baseball pitchers versus position players are established. There is limited information objectively comparing glenohumeral laxity in this same population.HypothesisBaseball pitchers have greater difference in side-to-side anteroposterior translation of their throwing shoulders compared with position players.Study DesignProspective cross-sectional study.MethodsCutaneous electromagnetic sensors quantified anteroposterior shoulder translation of college and professional baseball players. Range of motion was measured.ResultsNineteen position players and 37 pitchers were studied. Pitchers had a significant increase in external rotation of the dominant arm as compared with the nondominant arm (P = .02); the difference was not significant in position players (P = .34). The mean range of motion for pitchers’ dominant arm was 110° external rotation to 68° internal rotation, and it was 100° external rotation to 85° internal rotation...

Quantitative assessment of glenohumeral translation in baseball players: a comparison of pitchers versus nonpitching athletes.

Diagnostic value of patient characteristics, history, and six clinical tests for traumatic anterior shoulder instability.

n volleyball, the dominant shoulder of the athlete undergoes biomechanical and morphological adaptations; however, definitive conclusions about their exact nature, aetiology, purpose and associations with shoulder injury have not been reached. We present a systematic review of the existing literature describing biomechanical adaptations in the dominant shoulders of volleyball players and factors that may predispose to shoulder pain/injury. A thorough literature search via Medline, EMBASE and SCOPUS was conducted for original studies of volleyball players and 15 eligible articles were identified. Assessment of study quality was performed using the STROBE statement. The reviewed literature supports the existence of a glenohumeral internal rotation deficit (GIRD) and a possible (and less pronounced) external rotation gain in the dominant vs. the non-dominant shoulder of volleyball athletes. Unlike other overhead sports, the GIRD in volleyball athletes appears to be anatomical as a response to the repetitive overhead movements and not to be associated with shoulder pain/injury. Additionally, the dominant shoulder exhibits muscular imbalance, which appears to be a significant risk factor for shoulder pain. Strengthening of the external rotators should be used alongside shoulder stretching and joint mobilisations, core strengthening and optimisation of spike technique as part of injury management and prevention programmes.

The volleyball athlete’s shoulder: biomechanical adaptations and injury associations

https://www.azisks.com/wp-content/uploads/2015/10/Instability-Assessment-Reliability-of-Exam.pdf

Michael W. Wolff

Papers

Intrarater and interrater reliability of a manual technique to assess anterior humeral head translation of the glenohumeral joint