glenohumeral instability
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| mechanims | specific mechanism of injury maybe described, but chronic ant instability, is often caused by repetative microtrauma involving ER when the GH joint is ABD to 90* | pt may describe specific mechanism of injury but chronic post stability is generally caused by repetative microtrauma involving longitudinal force on the length of humerus while IR and the GH joint flex to 90* and HADD | congenital-aquired from repetative over head activity or post traumatic--a sensation of instability maybe described during mid range of motion
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| predisposition | joint hypermobiliy | joint hypermobility | joint hypermobility
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| inspection | flattened deltoid is possible as chronic cases can cause atrophy of deltand scapular muscles atrophy of RC muscles | chronic cases can cause atrophy of the deltoid muscles group, rotator cuff muscles, and scapular muscles | chronic cases can cause atrophy of the deltoid muscles and scapular muscles
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| palpation | tenderness of the anterior GH joint | tenderness of posterior GH joint | tenderness of anterior GH joint
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| AROM | decreased ER secondary to sensation of instability or pain | decreased IR | possible limitations at the end ROM secondary to a sensation of instability
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| MMT | pain and weakness during ER, in advanced cases and or pain | pain and weakness during IR in advanced cases | pain and weakness durint IR and ER
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| PROM | decreased ER secondary to sensaiton of instability and or pain | decreased IR | limited ROm due to pain and instability
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| stress tests and joint play | increased ant glid, although it maynot appear increased combared bilatterally due to bilaterally chronic instability, apprehension, relocation and suprise tests, posterior apprehension test, JERK test | increased post glide although may not appear increased due to contralateral side due to bilateral nature of instability in chronic cases | increased glide in all directions
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| special tests | apprehension, relocation test | posterior apprehension test, test for posterior instability in the plane of the scapular | apprehension, relocation tes, posterior apprehension instability in the plane of the scapula
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| onset | chronic | chronic | insidious or chronic
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| pain | difuse ache during ADLs along w/ sensation that the shoulder is loose when brought in ABD w/ ER | difuse ache during ADLs, pt reports shouldr feels unstable when it is brought across the body | p! in the shoulder that increase w/ ADLs, pt reports shoulder is "loose" w/ positions in extreme of rot motion--althought instability is multidir the c/c is typically p! during ER w/ the shoulder ABD to 90*
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