{"id":15389,"date":"2023-03-15T09:16:42","date_gmt":"2023-03-15T08:16:42","guid":{"rendered":"https:\/\/www.physiotutors.com\/?post_type=condition&#038;p=15389"},"modified":"2026-08-13T13:21:19","modified_gmt":"2026-08-13T11:21:19","slug":"shoulder-instability","status":"publish","type":"condition","link":"https:\/\/www.physiotutors.com\/conditions\/shoulder-instability\/","title":{"rendered":"Shoulder Instability"},"featured_media":15390,"template":"","tracking_tag":[2193,2312],"class_list":["post-15389","condition","type-condition","status-publish","has-post-thumbnail","hentry","tracking_tag-shoulder","tracking_tag-upper-extremity"],"acf":{"sections":[{"acf_fc_layout":"page-header-detail-page","background":{"background_image":15390,"background_image_alt_text":"Shoulder Instability"},"heading":"Shoulder Instability | Diagnosis & Treatment for Physiotherapists","subheading":"Shoulder","content_editor":"","button_type":"url","button_label":"","button_style":"button-five","button_internal_link":4646,"button_anchor":"","button_url":"https:\/\/study.physiotutors.com\/course\/rotator-cuff-related-shoulder-pain\/","button_file":"","label":""},{"acf_fc_layout":"submenu","links":[{"button_type":"anchor","button_label":"Introduction & Epidemiology","button_internal_link":null,"button_anchor":"section-number-3","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Clinical Picture & Examination","button_internal_link":null,"button_anchor":"section-number-4","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Treatment","button_internal_link":null,"button_anchor":"section-number-5","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Stiff Shoulder Online Course","button_internal_link":null,"button_anchor":"section-number-6","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Course Reviews","button_internal_link":null,"button_anchor":"section-number-7","button_url":"","button_file":null}],"dropdown_label":"Go to","button_right":{"button_type":"internal_link","button_label":"Become a member","button_style":"button-three","button_internal_link":22104,"button_anchor":"","button_url":"","button_file":""},"button_description":""},{"acf_fc_layout":"content-with-sidebar","content_editor":"<h2>Shoulder Instability | Diagnosis &amp; Treatment for Physiotherapists<\/h2>\r\nThe shoulder joint has a tremendous degree of mobility, which renders it prone to instability. While muscle forces control stability in mid-ranges of motion, clinical instability presents itself at end range of motion (<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/11888133\" target=\"_blank\" rel=\"noopener\">Doukas et al. 2001<\/a>).\u00a0 It is defined as abnormal motion of the humeral head on the glenoid, which presents as pain and\/or a sense of fear of displacement. Functional stability, which can be defined as maintenance of the humeral head centered within the glenoid fossa during shoulder motion, is achieved through synchronous coordination of static and dynamic components. These include negative intra-articular pressure, glenohumeral bony geometry, the capsulolabral complex, and synergistic muscle balance (<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/11888133\" target=\"_blank\" rel=\"noopener\">Doukas et al. 2001<\/a>).\r\n\r\nThe rotator cuff muscles serve to center the humeral head in the glenoid, thereby counteracting the translational forces that are generated by the prime movers of the shoulder. The glenoid labrum is known to increase the depth of the glenoid socket by approximately 50% in all directions and increases surface area as well.\r\n\r\nTraumatic instability can range from violent forces that can frankly dislocate the joint to more subtle forces that lead to plastic deformity of the static restraints.\r\nThe mechanism of anterior dislocation is typically an abrupt abduction\/external rotation force about the shoulder, while posterior most often happens due to seizures, fits, or electrocutions. It is also seen in sports with falls on the elbow, as well as tackling with an outstretched arm and a force into a posterior direction as is the case in rugby tackling.\r\n\r\nIn case of a dislocation, the following injuries are commonly seen:\r\n<ul>\r\n \t<li><strong>Glenoid fractures<\/strong> in 15 - 21% of cases (<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29505730\" target=\"_blank\" rel=\"noopener\">Kraeutler et al. 2018<\/a>,\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/18430839\" target=\"_blank\" rel=\"noopener\">Griffith et al. 2008<\/a>)<\/li>\r\n \t<li><strong>Bankart lesion:<\/strong> Detachment of the IGHL from the anterior glenoid and labrum in 84-97% of anterior dislocations (<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29505730\" target=\"_blank\" rel=\"noopener\">Kraeutler et al. 2018<\/a>,\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/25631890\" target=\"_blank\" rel=\"noopener\">Sedeek et al. 2014<\/a>)<\/li>\r\n \t<li><strong>Hill-Sachs lesion: <\/strong>Impression on the dorsal side of the humeral head after anterior dislocation in 41-83% (<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29505730\" target=\"_blank\" rel=\"noopener\">Kraeutler et al. 2018<\/a>,\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/25231817\" target=\"_blank\" rel=\"noopener\">Ozaki et al. 2014<\/a>)<\/li>\r\n \t<li><strong>Rotator cuff tears<\/strong> in 1,2% of patients in a study with a mean age of 24 (<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29505730\" target=\"_blank\" rel=\"noopener\">Kraeutler et al. 2018<\/a>) up to 33.4% prevalence for rotator cuff tears and\/or fractures of the greater tuberosity in a study with mean age of 47.6 years (<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22218378\" target=\"_blank\" rel=\"noopener\">Robinson et al. 2012<\/a>)<\/li>\r\n \t<li><strong>Neural injury<\/strong> to the axillary nerve and\/or other parts of the brachial plexus in 13,5%\u00a0(<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22218378\" target=\"_blank\" rel=\"noopener\">Robinson et al. 2012<\/a>)<\/li>\r\n<\/ul>\r\n<img class=\"wp-image-9829 aligncenter\" src=\"https:\/\/physiotutors.com\/wp-content\/uploads\/study\/2017\/03\/Instability-triangle-460x320.jpg\" alt=\"\" width=\"529\" height=\"368\" \/><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/28979601\" target=\"_blank\" rel=\"noopener\">Jaggi et al. (2017)<\/a> propose the Stanmore classification for the rehabilitation of shoulder instability. They mention that both structural (rotator cuff, surface area of contact, capsulolabral complex) and non-structural (central and peripheral nervous system) components are contributing to shoulder instability and stress that a continuum exists between pathologies.\r\nThe structural elements may be congenitally abnormal, comprise abnormal collagen, acquired micro traumatic lesions over time (atraumatic structural), or be damaged by extrinsic factors (traumatic structural). The non-structural elements can be congenitally abnormal or acquired over time as perturbations of neuromuscular control.\r\nThe Stanmore classification is as follows:\r\n<strong>Pole I: Traumatic<\/strong> (TUBS = Traumatic, unilateral, Bankart lesion, surgery)\r\n<strong>Pole II: Atraumatic<\/strong> (AMBRI = atraumatic, multidirectional, bilateral, rehabilitation, inferior capsular shift)\r\n<strong>Pole III: Neuromuscular<\/strong>\r\n\r\n&nbsp;\r\n\r\n<strong>Epidemiology<\/strong>\r\n\r\nShields et al. (2017) retrospectively examined collected trauma databases and found an incidence rate of 21.9 dislocations per 100.000 people in an urban population. They report a peak incidence of 42.1 and 50.9 in the 15-24 and\u00a0\u226585 age group for males and a peak of 45.7 for females in the age group between 65 and 74.\r\n<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/15219891\" target=\"_blank\" rel=\"noopener\">Finhoff et al. (2004)<\/a> constitute that more than 75% of cases of shoulder instability are due to trauma, with the\u00a0remaining 25% categorized as non-traumatic.\r\n<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22112155\" target=\"_blank\" rel=\"noopener\">Blomquist et al. (2012) <\/a>report that around 75% of instabilities are in the anterior direction, most of them as a result of sports injuries or trauma.\r\nPosterior instabilities make up around 20%, most often due to fits, seizures, or electrocutions, although sports injuries or trauma can play a role here as well.\r\nThe remaining 5% of multi-directional instability is most often seen in people with hypermobility."},{"acf_fc_layout":"content-with-sidebar","content_editor":"<h3><strong>Clinical Picture &amp; Examination<\/strong><\/h3>\r\nIt's important to evaluate the following items in your patient history:\r\n<ul>\r\n \t<li><strong>Age:\u00a0<\/strong> below or above 25?<\/li>\r\n \t<li><strong>Mechanism of injury:<\/strong> torn (TUPS), worn (AMBRI), or born (muscle patterning \/ non-structural)<\/li>\r\n \t<li><strong>The direction of instability:<\/strong> anterior, posterior, or multi<\/li>\r\n \t<li><strong>Severity:<\/strong> dislocation or subluxation?<\/li>\r\n \t<li><strong>Frequency:<\/strong> primary or recurrent<\/li>\r\n<\/ul>\r\n<img class=\"alignnone size-medium wp-image-9907\" src=\"https:\/\/physiotutors.com\/wp-content\/uploads\/study\/2017\/03\/Polar-types-of-instability-3-460x226.jpg\" alt=\"\" width=\"460\" height=\"226\" \/>\r\n\r\nDepending on the answers, you are able to place your patient somewhere on the continuum between the 3 poles as described earlier by\u00a0Jaggi et al. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/28979601\" target=\"_blank\" rel=\"noopener\">(2017)<\/a>.\r\nIt's important to realize that psychological components like fear, anxiety and avoidance do play a role and should be evaluated as well.\r\n\r\n<em><strong>Examination<\/strong><\/em>\r\n\r\nAfter a thorough history that includes onset, circumstances, direction, frequency, and magnitude, the clinical examination is the essential first step in determining the pattern and degree of instability.\r\n\r\n<img class=\"wp-image-12136 aligncenter\" src=\"https:\/\/physiotutors.com\/wp-content\/uploads\/study\/2017\/03\/Anterosuperior-460x460.png\" alt=\"\" width=\"423\" height=\"423\" \/>\r\n\r\n<strong><em>Anterior instability<\/em>\r\n<\/strong>\r\n\r\nIn order to evaluate anterior instability, a combination of the Apprehension and the Relocation Test yields a sensitivity of 67% with a specificity of 98%, thus basically confirming the presence of anterior structural instability (<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22773322\" target=\"_blank\" rel=\"noopener\">Hegedus et al. 2012<\/a>).\r\n<div class=\"embed-container\">\r\n\r\n[embed]https:\/\/www.youtube.com\/watch?v=jZ29dAXKA5M[\/embed]\r\n\r\n<\/div>\r\nThe apprehension test is usually directly followed by the relocation test:\r\n<div class=\"embed-container\">\r\n\r\n[embed]https:\/\/www.youtube.com\/watch?v=YX1uJhjhwWg[\/embed]\r\n\r\n<\/div>\r\nAn additional orthopedic test that is often performed as a follow-up to the Apprehension and Relocation Test is the <a href=\"https:\/\/www.physiotutors.com\/wiki\/release-test\/\">Release Test<\/a>.\r\n\r\n&nbsp;\r\n\r\n<strong><em>Posterior instability<\/em><\/strong>\r\n\r\nPostereroinferior instability is best assessed with the Jerk Test, which is a very accurate test with a sensitivity of 90% and a specificity of 85% (<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/15572311\" target=\"_blank\" rel=\"noopener\">Kim et al. 2004<\/a>). The authors also describe that a painful Jerk Test was a predictor of failure of conservative treatment. At the same time, in the painless <span class=\"highlight\">jerk<\/span>\u00a0group (with a positive test due to a clunk) 93% responded to the rehabilitation program after a mean of 4 months.\r\n<div class=\"embed-container\">\r\n\r\n[embed]https:\/\/www.youtube.com\/watch?v=j_qG1MNOws8[\/embed]\r\n\r\n<\/div>\r\nOther orthopedic tests for posterior instability are:\r\n<ul>\r\n \t<li><a href=\"https:\/\/www.physiotutors.com\/wiki\/kims-test\/\">Kim's Test<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.physiotutors.com\/wiki\/miniaci-test\/\">Miniaci Test<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.physiotutors.com\/wiki\/porcellini-test\/\">Porcellini Test<\/a><\/li>\r\n<\/ul>\r\n&nbsp;\r\n\r\n<strong><em>Inferior instability<\/em><\/strong>\r\n\r\nIn order to evaluate inferior instability, you can perform the Sulcus Test or Sulcus Sign. However, no sensitivity or specificity values are known for this test. At the same time, the test reached only moderate inter-rater reliability with a Kappa value of\u00a0\u043a=0.43 in a study done by Eshoj et al. (2018).\r\n<div class=\"embed-container\">\r\n\r\n[embed]https:\/\/www.youtube.com\/watch?v=vV7u2JtdYWI[\/embed]\r\n\r\n<\/div>\r\nAnother orthopedic test for inferior instability is the <a href=\"https:\/\/www.physiotutors.com\/wiki\/gagey-test\/\">Gagey Test<\/a>. In order to assess multidirectional instability, the <a href=\"https:\/\/www.physiotutors.com\/wiki\/load-and-shift-test\/\">Load and Shift Test<\/a> can be performed.\r\nIn case your patient falls into the 'Born Loose' category, you should also assess for hypermobility. The <a href=\"https:\/\/www.physiotutors.com\/wiki\/beighton-score\/\">Beighton score<\/a> together with the Brighton Criteria is a method to determine if your patient is suffering from congenital hypermobility syndrome.\r\n[cta]"},{"acf_fc_layout":"content-with-sidebar","content_editor":"<h3><strong>Treatment<\/strong><\/h3>\r\nThe aim of physiotherapy in the treatment of shoulder instability is to restore pain-free and normal motor control of the affected shoulder by using several distinct techniques that are applied in an appropriate and timely manner suited to the individual patient. Successful treatment is highly dependent upon the correct clinical diagnosis, identification of anatomical structural defects, and abnormal movement patterns so that rehabilitation programs can be designed accordingly (<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/28979601\" target=\"_blank\" rel=\"noopener\">Jaggi et al. 2017).<\/a>\r\n\r\nShoulder dislocations have high recurrence rates of up to almost 90% in some populations and a low return to activity rate of sometimes below 50%. While surgery seems to be effective in young males who partake in physically demanding sporting activities, <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27535060\/\" target=\"_blank\" rel=\"noopener\">Eljabu et al. (2017)<\/a> report superior outcomes of conservative treatment compared to surgery in many other cases.\r\n\r\nThe treatment aim in the non-acute setting for shoulder instability is to minimize the risk of recurrence and improve pain and function. Physiotherapy usually starts after 4-12 weeks but can start as soon as the patient can tolerate exercise.\r\nIn this video below we will present you with exercise examples for the early and mid-stage rehab and part 2- will show you exercises and drills for late-stage rehab and return to sport. Closed-kinetic chain exercises provide several benefits for patients suffering from shoulder instability: They decrease joint shear and translation, they increase joint proprioception via joint compression and they improve muscle activation.\r\n<div class=\"embed-container\">\r\n\r\n[embed]https:\/\/www.youtube.com\/watch?v=12gUmyq-6xc[\/embed]\r\n\r\n<\/div>\r\nIn part 1 of this video series, we presented closed and semi-closed kinetic chain exercises to rehab shoulder instability in the early and mid-phase of rehab. In the following video we will continue with more advanced closed-chain exercises and open-chain and dynamic drills.\r\n\r\nIn case your patient is able to tolerate closed and semi-closed kinetic chain exercises, he or she is able to move on to more advanced closed-kinetic chain exercises and open chain perturbations. This is usually the case after around 2 months.\r\n<div class=\"embed-container\">\r\n\r\n[embed]https:\/\/www.youtube.com\/watch?v=12gUmyq-6xc[\/embed]\r\n\r\n<\/div>\r\nSo when do you know if your patient is ready to return to play?\r\nGenerally, patients should be able to have a full pain-free range of motion and feel psychologically ready to return to sports. On top of that, strength in all planes should at least be 90% compared to the healthy side. A test that you can use to help guide return-to-play decision-making is the y-balance test for the upper quarter.\r\n\r\nAt last, proprioception is often reduced in the unstable shoulder when compared to the uninjured side. <a href=\"https:\/\/www.physiotutors.com\/wiki\/shoulder-joint-positioning-sense\/\">Shoulder Joint Positioning Sense Assessment<\/a> can help you to detect and rehab impairments.\r\n\r\nDo you want to learn more about Shoulder Instability? Then check out the following resources:\r\n<ul>\r\n \t<li><a href=\"https:\/\/www.physiotutors.com\/podcasts\/shoulder-instability-anju-jaggi\/\">Physiotutors Podcast Episode 50: The Unstable Shoulder with Anju Jaggi<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.physiotutors.com\/research\/recurrent-instability-shoulder-dislocation\/\">Predicting Recurrent Instability of the Shoulder (PRIS) after First-Time Traumatic Anterior Dislocation<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.physiotutors.com\/research\/neuromuscular-exercises-shoulder-dislocation\/\">Neuromuscular Exercises for Anterior Shoulder Dislocation<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.physiotutors.com\/research\/high-load-strengthening-shoulder-hypermobility\/\">Short-term effectiveness of high-load strengthening in patients with hypermobile shoulders<\/a><\/li>\r\n<\/ul>\r\n&nbsp;\r\n<h3><strong>References<\/strong><\/h3>\r\n<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/22112155\/\" target=\"_blank\" rel=\"noopener\">Blomquist, J., Solheim, E., Liavaag, S., Schroder, C. P., Espehaug, B., &amp; Havelin, L. I. (2012). Shoulder instability surgery in Norway: the first report from a multicenter register, with 1-year follow-up.\u00a0Acta orthopaedica,\u00a083(2), 165-170.<\/a>\r\n\r\n<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/11888133\/\" target=\"_blank\" rel=\"noopener\">Doukas, W. C., &amp; Speer, K. P. (2001). Anatomy, pathophysiology, and biomechanics of shoulder instability.\u00a0Orthopedic Clinics,\u00a032(3), 381-391.<\/a>\r\n\r\n<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27535060\/\" target=\"_blank\" rel=\"noopener\">Eljabu, W., Klinger, H. M., &amp; Von Knoch, M. (2017). The natural course of shoulder instability and treatment trends: a systematic review.\u00a0<i>Journal of Orthopaedics and Traumatology<\/i>,\u00a0<i>18<\/i>, 1-8.<\/a>\r\n\r\n<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/15219891\/\" target=\"_blank\" rel=\"noopener\">Finnoff, J. T., Doucette, S., &amp; Hicken, G. (2004). Glenohumeral instability and dislocation.\u00a0Physical Medicine and Rehabilitation Clinics,\u00a015(3), 575-605.<\/a>\r\n\r\n<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/18430839\/\" target=\"_blank\" rel=\"noopener\">Griffith, J. F., Antonio, G. E., Yung, P. S., Wong, E. M., Yu, A. B., Ahuja, A. T., &amp; Chan, K. M. (2008). Prevalence, pattern, and spectrum of glenoid bone loss in anterior shoulder dislocation: CT analysis of 218 patients.\u00a0American Journal of Roentgenology,\u00a0190(5), 1247-1254.<\/a>\r\n\r\n<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/22773322\/\" target=\"_blank\" rel=\"noopener\">Hegedus, E. J., Goode, A. P., Cook, C. E., Michener, L., Myer, C. A., Myer, D. M., &amp; Wright, A. A. (2012). Which physical examination tests provide clinicians with the most value when examining the shoulder? Update of a systematic review with meta-analysis of individual tests.\u00a0British journal of sports medicine,\u00a046(14), 964-978.<\/a>\r\n\r\n<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/28979601\/\" target=\"_blank\" rel=\"noopener\">Jaggi, A., &amp; Alexander, S. (2017). Suppl-6, M13: Rehabilitation for shoulder instability\u2013current approaches.\u00a0The open orthopaedics journal,\u00a011, 957.<\/a>\r\n\r\n<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/29505730\/\" target=\"_blank\" rel=\"noopener\">Kraeutler, M. J., McCarty, E. C., Belk, J. W., Wolf, B. R., Hettrich, C. M., Ortiz, S. F., ... &amp; Zhang, A. L. (2018). Descriptive epidemiology of the MOON shoulder instability cohort.\u00a0The American journal of sports medicine,\u00a046(5), 1064-1069.<\/a>\r\n\r\n<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/25231817\/\" target=\"_blank\" rel=\"noopener\">Ozaki, R., Nakagawa, S., Mizuno, N., Mae, T., &amp; Yoneda, M. (2014). Hill-Sachs lesions in shoulders with traumatic anterior instability: evaluation using computed tomography with 3-dimensional reconstruction.\u00a0The American journal of sports medicine,\u00a042(11), 2597-2605.<\/a>\r\n\r\n<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/22218378\/\" target=\"_blank\" rel=\"noopener\">Robinson, C. M., Shur, N., Sharpe, T., Ray, A., &amp; Murray, I. R. (2012). Injuries associated with traumatic anterior glenohumeral dislocations.\u00a0JBJS,\u00a094(1), 18-26.<\/a>\r\n\r\n<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/25631890\/\" target=\"_blank\" rel=\"noopener\">Sedeek, S. M., Abd Razak, H. R. B., Ee, G. W., &amp; Tan, A. H. (2014). First-time anterior shoulder dislocations: should they be arthroscopically stabilised?.\u00a0Singapore medical journal,\u00a055(10), 511.<\/a>"},{"acf_fc_layout":"cta-special","heading":"It\u2019s Time to Stop Nonsense Treatments for Shoulder Pain and To Start Delivering Evidence-based Care","subheading":"Online Course","button_type":"url","button_label":"Learn More","button_style":"button-link-one","button_internal_link":null,"button_anchor":"","button_url":"https:\/\/study.physiotutors.com\/course\/rotator-cuff-related-shoulder-pain\/","button_file":null,"image":{"image_image":8754,"image_image_alt_text":"Shoulder Online Course"},"background":{"background_image":8702,"background_image_alt_text":"Physiotherapy online course"}},{"acf_fc_layout":"slider-reviews-wp-review-slider-pro","heading":"What customers have to say about this course","subheading":"Reviews","content":"[wprevpro_usetemplate tid=\"14\"]"}]},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Shoulder Instability | Diagnosis &amp; Treatment for Physiotherapists<\/title>\n<meta name=\"description\" content=\"Shoulder Instability is a common complaint after dislocation, but also in overhead athletes and hypermobile patients. 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