Article Text

PDF
Multidirectional instability of the glenohumeral joint: an unstable classification resulting in uncertain evidence-based practice
  1. Kajsa Johansson
  1. Correspondence to Dr Kajsa Johansson, Head of the division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, Sweden; kajsa.johansson{at}liu.se

Statistics from Altmetric.com

The aim of this editorial is to discuss the pros and cons of some of the current classification systems of shoulder instability, with special emphasis on instability in more than one direction, and to summarise the basis for future clinical reasoning and research.

The term ‘multidirectional instability’ (MDI) is commonly used in adolescents and young adults, who can sometimes voluntarily subluxate their glenohumeral joints. They report pain, instability and shoulder disability, and present with symptomatic abnormal movement of the joint in two or more directions; the abnormal movement may predominate in one direction. The joint laxity may be congenital (in which case, it is often bilateral), or may due to the microtrauma of highly repetitive end-range movements, for example, in overhead athletes.

WHICH INSTABILITY CLASSIFICATION SYSTEM COULD BE RECOMMENDED?

Classifying patients with shoulder instability is a challenge. Rockwood1 described four types of instability and patients with MDI fit into type 3, voluntary subluxation with no history of trauma, or type 4, atraumatic involuntary subluxation. Later, Kessel and Bayley …

View Full Text

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles