Multidirectional instability refers to a problem in the shoulder where the head of the upper arm bone isn’t being properly kept in place in the shoulder joint. This condition is caused by repetitive overuse, which stretches the joint capsule – the soft tissue surrounding the joint – and gives the head of the upper arm bone greater range of motion than it should have. Multidirectional instability is experienced most commonly by athletes who play sports that require an extreme range of shoulder motion, particularly the types of overhead movements involved in baseball and swimming. Individuals with multidirectional instability may experience pain and weakness in their shoulder joint.
Diagnosing this condition is done mostly through stability tests, which assess the movement of the upper arm bone in the shoulder socket while the arm is being moved in different directions. In contrast with unidirectional instability, which is usually the result of an acute injury and involves looseness in one direction, multidirectional instability is defined by looseness in two directions or more. For individuals who are experiencing pain or weakness in their shoulder, X-rays and MRIs may also be used to rule out other skeletal or soft tissue injuries.
When a diagnosis of multidirectional instability has been established, treatment options include:
- Conservative treatments – The primary treatment for multidirectional instability is physical therapy. The goal of this treatment is to stretch the parts of the shoulder that are tight and strengthen the muscles that support the joint. Physical therapy will begin with gentle stretches and will gradually increase in intensity over time.
- Surgery – For a limited group of patients, surgery may be recommended if conservative treatments fail to provide sufficient relief. There are both arthroscopic and traditional surgical procedures that can be performed to reduce the size of the joint capsule and help keep the head of the upper arm bone in place.
To determine if you have multidirectional instability and learn more about potential treatment options, schedule an appointment with Dr. Ira Guttentag at Florida Medical Orthopaedics, Sports Medicine & Spine. Dr. Guttentag is a shoulder expert who has successfully treated many cases of instability through the years.