What’s glenohumeral instability?

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Glenohumeral instability is a condition in which the shoulder joint slips partially or completely out of place, often causing pain that increases with movement. The shoulder joint, or glenohumeral joint, forms between the humerus, or upper arm bone, and the scapula, or scapula. It consists of the round end, or head, of the humerus that sits within a hollow part of the scapula known as the glenoid fossa. Because the shoulder has a wide range of motion, it is not as stable as many other joints and is easily dislocated. Glenohumeral instability can be a birth condition or it can be the result of an accident or other unknown cause.

Sometimes people are born with glenohumeral instability, possibly due to joint deformity or as a side effect of another disease, such as Ehlers-Danlos syndrome. In Ehlers Danlos syndrome, the body’s tissues are too weak and flexible, including the ligaments and muscles that hold joints together. This means that glenohumeral ligament sprains are more likely to occur, leading to a loose joint. In some people, the shoulder joint seems to lose its stability, for unknown reasons. Accidental injuries are a known cause of glenohumeral instability and can involve damage to bones, muscles, ligaments, or the capsule surrounding the shoulder joint.

Typically, the most common symptom of glenohumeral instability is having a sore shoulder joint that becomes even more painful when the arm is held in certain positions or when certain movements are performed. When the instability is the result of an accident, the person may report falling onto an outstretched hand or being in an automobile accident. Where no accidental injury has occurred, the person may experience pain that comes and goes, aggravated by use and relieved by rest. Some patients notice the humeral head slipping out of place or the looseness associated with the joint. Non-accidental glenohumeral instability tends to affect both shoulders and the joint is loose in all directions.

Treatment of glenohumeral instability varies according to the type of instability and the patient’s age and motivation. In the event of an accidental injury, shoulder sprains can be initially immobilized. Then the patient performs a course of strengthening exercises to stabilize the joint. For some patients, surgery is the preferred treatment and conventional or keyhole surgical methods may be used. A possible complication after surgery is decreased range of motion of the glenohumeral joint, which could represent significant shoulder disability for some athletes.

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