What is the role of shoulder instability in rotator cuff injuries?

Updated: Oct 25, 2018
  • Author: Gerard A Malanga, MD; Chief Editor: Craig C Young, MD  more...
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Most people with ligamentous laxity are functionally stable. In patients with inherent shoulder or generalized laxity, instability may develop with minimal or no injury.

Ligamentous laxity may be acquired by repetitive stretching of the joint, as observed in swimmers, gymnasts, and tennis players.

Dynamic stability may be lost if the shoulder becomes deconditioned. As a result, a vicious self-perpetuating cycle of instability, less use, more muscle weakness, and more instability is present.

These patients frequently have relative rotator cuff muscle weakness, particularly the external rotators and scapular stabilizers.

Subtle instability patterns may contribute to the impingement development.

Increased anterior and superior translation of the humeral head, as observed in athletes with generalized laxity and multidirectional instability of the shoulder, may predispose to impingement along the coracoacromial arch, resulting in rotator cuff injury.

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