Related Experiment Video
Updated: Oct 16, 2025

Measuring 3D In-vivo Shoulder Kinematics using Biplanar Videoradiography
Published on: March 12, 2021
The association between crawling as a first mode of mobilisation and the presentation of atraumatic shoulder
Deborah J Williams1, Anju Jaggi1, Tania Douglas1
1Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK.
Insights
Infants who did not crawl as their first mode of mobility had a higher prevalence of atraumatic shoulder instability. This suggests a potential link between early developmental milestones and shoulder instability in children.
Area of Science:
- Pediatric Orthopedics
- Developmental Pediatrics
- Sports Medicine
Background:
- Atraumatic shoulder instability can significantly impact an individual's quality of life.
- Understanding the origins of atraumatic shoulder instability is crucial for effective management.
Purpose of the Study:
- To investigate the association between an infant's first mode of mobility and the development of atraumatic shoulder instability.
- To explore potential links between early developmental milestones and shoulder joint health.
Main Methods:
- Retrospective cohort study comparing 50 patients with atraumatic shoulder instability to 50 controls.
- Assessed the primary outcome of atraumatic shoulder instability and whether crawling was the first mode of mobility.
- Utilized a Pearson chi-squared test to analyze the association between crawling and shoulder instability.
Main Results:
- A significant association was found between crawling and shoulder instability (p=0.001).
- Patients with atraumatic shoulder instability showed a higher prevalence of not crawling as their first mode of mobility compared to controls.
Conclusions:
- A potential association exists between developmental milestones, specifically crawling, and atraumatic shoulder instability.
- Further research is required to establish causality and explore this relationship further.
- Inquiring about developmental history may inform targeted rehabilitation for shoulder instability.
Background And Purpose:
To investigate if there is an association between whether an infant crawls as their first mode of mobilisation and the subsequent presentation of atraumatic shoulder instability.
Patients And Methods:
A retrospective cohort of 50 consecutive patients who had presented to a national specialist centre for shoulder instability with a diagnosis of atraumatic instability was compared with a cohort of 50 participants who did not have shoulder instability. Primary outcomes were presence of atraumatic shoulder instability and whether or not the patient crawled as their first mode of mobility. A Pearson chi-squared test was used to evaluate associations.
Results:
There was a significant association between crawling and shoulder instability (X 2(1) ≥ 11.93, p = 0.001) with a higher prevalence of non-crawlers in the group with shoulder instability compared to the control group.
Interpretation:
There may be an association between developmental milestones and atraumatic shoulder instability. It cannot be concluded from this study whether association is causal and additional research is needed to further investigate this relationship. Asking patients presenting with shoulder instability about their developmental milestones as part of a full subjective history could guide a more targeted sensorimotor rehabilitation programme.

