An estimated 50% of the general population suffers with shoulder pain at some point in their life and up to 50% of those individuals seek medical attention. A shoulder rehabilitation program must address both the mechanical and sensory functions of articular structures by incorporating a proprioceptive training element within the normal protocol. The objective of proprioception rehabilitation is to enhance cognitive appreciation of the respective joint relative to position and movement, and to enhance muscular stabilisation of the joint in the absence of structural restraints. If these objectives are properly addressed, the restoration of the proprioceptive mechanism will prevent further disability of the shoulder joint. The characteristics of closed chain exercises include greater compressive forces, joint congruency, decreased shear, stimulation of mechanoreceptors and enhanced dynamic stabilisation. The characteristics of open chain exercises are distraction and rotary forces, promotion of a stable base, joint mechanoreceptor deformation, concentric acceleration and eccentric deceleration and simulated function. There is a large base of literature that supports the conclusions that deficits in proprioception are linked to shoulder instabilities and more recently to osteoarthritis and impingement syndromes. The literature is not consistent in the definitions of shoulder instability which makes it difficult to categorise and research separate types of instability.
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