Microinstability of the Shoulder

Jun-Gyu Moon; Jung-Hoon Kim

doi:10.5763/kjsm.2018.36.4.173

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Moon and Kim: Microinstability of the Shoulder

Review Article

The Korean Journal of Sports Medicine 2018; 36(4): 173-179.

Published online: 7 December 2018

DOI: https://doi.org/10.5763/kjsm.2018.36.4.173

Microinstability of the Shoulder

Jun-Gyu Moon, Jung-Hoon Kim

Department of Orthopedic Surgery, Korea University Guro Hospital, Seoul, Korea.

Correspondence: Jun-Gyu Moon. Department of Orthopedic Surgery, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul 08308, Korea. Tel: +82-2-2626-3089, Fax: +82-2-2626-1163, moonjg@korea.ac.kr

Received 15 October 2018 Revised 19 November 2018 Accepted 27 November 2018

The Korean Society of Sports Medicine

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A variety of theories have been reported as causes of shoulder pain in overhead throwing athletes. Recently, an explanation with microinstability of the shoulder and internal impingement has been proposed. The concept of the microinstability is that pathologic laxity of the anterior capsule caused by repeated abduction and external rotation of the shoulder leads to abnormal glenohumeral biomechanics and causes internal impingement of the shoulder. Based on the understanding of the pathology, it is recommended to identify the causes of shoulder pain in the overhead throwing athletes and perform appropriate rehabilitation or surgical treatment.

Keywords: Shoulder, Microinstability, Internal impingement

Figures and Tables

Fig. 1

The pathomechanism of the microinstability. (A) With the shoulder in a position of abduction and external rotation, humeral head produces a cam effect of anteroinferior capsule, by tensioning the capsule. (B) With a posterosuperior shift of the glenohumeral contact point caused by posterior capsule tightness, cam effect of the proximal humerus is reduced. This creates a relative redundancy in the anteroinferior capsule.

Fig. 2

(A) A coronal image of 37-year-old professional pitcher with a partial thickness articular side rotator cuff tear (arrow). (B) Bennett lesion (arrow), which is an ossification on the posteroinferior glenoid rim on an axial magnetic resonance image.

Fig. 3

Sleeper stretch. The patient lies on the side with the involved arm against the table and perpendicular to the body. The shoulder and elbow are flexed 90° and the patient push the forearm toward the table by using non-involved arm.

Fig. 4

Type 2B (posterior subtype) SLAP (superior labrum anterior to posterior) tear and repair (A) with suture anchors (B).

Notes

^{Conflict of Interest} No potential conflict of interest relevant to this article was reported.

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