CLINICAL FEATURES: A 23-year-old professional hockey player with recurrent left shoulder pain and instability. He had two previous unsuccessful shoulder operations to correct the instability. He reported that the shoulder "slips out" in positions of abduction and external rotation or when the left arm is moved suddenly above shoulder height. The patient was still playing hockey professionally at the time of the initial visit and did not want to have to take time off for another surgery, so he chose to attempt a conservative approach.
INTERVENTION AND OUTCOME: The patient had undergone strength training for rehabilitation after each of the previous two shoulder operations and had very strong rotator cuff and scapular musculature. Proprioceptive testing revealed a poor response in the left shoulder compared with the right shoulder. Two subjective outcome measures were used to determine the effectiveness of the treatment protocol in reducing the symptoms of recurrent shoulder instability. Much of the treatment focused on proprioceptive training, soft tissue mobilization, and improving joint function.
CONCLUSION: This case demonstrates the potential benefit of chiropractic management and proprioceptive exercises to decrease the symptoms of recurrent shoulder instability.
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