The effect of shoulder muscle training in patients with recurrent shoulder dislocations.
Thirty-three shoulders in 29 patients with recurrent shoulder dislocations, of both traumatic and nontraumatic type, have been studied. The patients suffered from muscle weakness, and had also a hypotrophy of the supra- and infraspinatus muscles. A special training program using an isokinetic pulley-weight apparatus, for muscle strength, coordination and endurance training of the rotator-cuff muscles and the deltoid were given all patients. Shoulder flexors, internal and external rotator muscles were trained three times a week, during a period of 8 weeks. At follow-up one year after completion of the specific training program all shoulders except five were improved. Five shoulders had remaining instability. Four of these patients had generalized joint laxity and a much decreased humeral head retroversion, and were later on stabilized with a rotational osteotomy of the proximal humerus. One of the shoulders with remaining instability was of traumatic type with normal skeletal anatomy. This patient was later on stabilized with a Putti-Platt procedure. We conclude that most of the patients were relieved from pain, and had decrease or cessation of their dislocations. Factors indicating a less good result of training were an abnormal skeletal anatomy, and/or a multidirectional type of instability.
Broström
L A
LA
Department of Orthopedics, Karolinska Hospital, Stockholm, Sweden.
Kronberg
M
M
Németh
G
G
Oxelbäck
U
U
D000328:Adult; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D007593:Joint Instability / Q000503:physiopathology; D008297:Male; D059408:Pain Management; D010807:Physical Endurance / Q000502:physiology; D012008:Recurrence; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000033:anatomy & histology