MANAGING POSTERIOR SHOULDER INSTABILITY - RESULT-ORIENTED TECHNIQUES

Posterior shoulder instability, a recently recognized source of pain i n throwing, overhand, and contact sports, usually results from repetit ive microtrauma or a single traumatic episode. Physical signs often ar e not obvious, so targeted physical tests, provocative maneuvers, and radiographic studies are needed to identify abnormal humeral head tran slation. Examination under anesthesia or arthroscopy may be required. The first line of treatment focuses on an intensive physical therapy p rotocol that strengthens the infraspinatus, teres minor, and posterior deltoid muscles. Surgery may be indicated, but ideal technique is a m atter of debate.