Managing Posterior Shoulder Instability

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