Br J Sports Med 44:333-340 doi:10.1136/bjsm.2009.059311
  • Shoulder injuries in athletes

Rehabilitation for shoulder instability

  1. S Lambert
  1. Royal National Orthopaedic Hospital, Stanmore, UK
  1. Correspondence to Ms Anju Jaggi, Shoulder & Elbow Unit, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore HA7 4LP, UK; anju.jaggi{at}
  • Accepted 6 January 2010


Both structural and non-structural components can contribute to shoulder instability. Classification and therefore management must recognise these factors to achieve functional stability. This paper discusses a classification system proposing three types of shoulder instability recognising the structural and non-structural components and that a continuum exists between pathologies. Structural causes can be addressed with surgical intervention, but non-structural causes such as altered neuromuscular control within the rotator cuff should be addressed conservatively. The purpose of this article is to describe the types of instability and guide appropriate management, helping to avoid surgery in inappropriate cases and ensure that effective rehabilitation has been achieved.


  • Patient consent Obtained.

  • Competing interests None.

  • Provenance and peer review Commissioned; not externally peer reviewed.

  • Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.