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Shoulder instability, chronic

1. Risk kinds of sport:

Kinds of over head sport: Tennis, swimming, kinds of throwing sports

2. Anatomy:

Ball joint, mainly muscularly led; see also “Luxations”

3. Function:

Move the arm in all directions (lift, a lowering, sideways, horizontal, in and outward rotation)

4. Injury mechanism:

- Consequence of volume instabilities (through e.g. repeated pulling). Thus over mobility of the joint by longlasting or high stress - shearing movement
- mainly front instability
- particularly with over head loads

5. Symptoms:

- Musculature of the joint decreases
- fear of luxation
- repeated sub luxations (joint nearly dislocates )
- Swelling the joint
- Pain after longer or high stress (above all over head)

6. First measures:

- with swelling or pain - cooling
- Discharge of the joint by avoidance of stressing movements (particularly over head)

7. Diagnostics:

- clinical investigation by the physician
- Roentgen
- Nuclear spin tomography usually with direct contrast liquid given in the joint

8. Therapy:

a) Conservative therapy
- Antiphlogistika (entzündungshemmend, abschwellend)
- Injections possible
b) Operational therapy:
- Cap volume rationalization openly or arthroskopisch (decision dependant on individual case)

9. Physiotherapie/rehablitation:

- Strengthening the shoulder-stabilizing musculature by patient gymnastic
- Electrical therapy

10. Prevention:

- Strengthening the shoulder-stabilizing musculature
- Improvement of the mobility of the chest spinal column
- Improvement of the technology
- Improvement of the co-ordination

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