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Shoulder instability physiotherapy London

If you’re looking for shoulder instability physiotherapy, and need a therapist who is thorough and thinks outside the traditional physiotherapy box, then look no further!

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Just call my London team on
0207 175 0150 or use the form below and let me help you get better.

Just call my London team on 0207 175 0150 or use the form here.
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Shoulder instability physiotherapy

An unstable shoulder is one where the head of the upper arm bone or humerus (the “ball”) keeps popping out of the acetabulum of the shoulder blade (the “socket”).  It may be subluxing (coming out partially) or dislocating (where it comes all the way out).

The ball is held in the socket by three systems:

  • the shape of the bones – the socket needs to be deep enough for the ball to sit in it neatly, with the curve of the ball mirroring the curve of the socket, and the labrum – a ring of cartilage that deepens the “bowl” of the socket – intact
  • the integrity and normal structure of the ligaments and capsule, the tough, relatively passive soft tissue structures that hold the bones together
  • the neuromuscular activity – your brain needs to tell your muscles when to activate, and your muscles need to be strong enough to hold the ball in the socket when it’s being challenged
     

If one of these systems is compromised, it makes shoulder stability more difficult.

Shoulder instability usually happens as the result of a traumatic dislocation (eg a rugby tackle gone wrong, or a bad fall from a bike etc) which doesn’t fully heal, resulting in overstretched ligaments; or it could be because of a connective tissue disorder such as Ehlers-Danlos Syndrome (hypermobility type) where the ligaments are more elastic.

What to expect from a shoulder instability physio assessment

The first thing to expect is that we’ll be having a long chat!  I need to understand how easily your shoulder pops out and in which direction – and what you’re hoping to be able to do with it!  For example, are we aiming to get you back to being able to carry a bag of shopping; or do you want to be able to play full-contact rugby or serve a tennis ball at 100mph?

Next, we’ll look at your shoulder and everything that may be impacting on your ability to control the ball within the socket.  We need to understand whether your shoulder instability is due to bony structures, ligamentous integrity or neuromuscular control.

Working this out may involve imaging such as X-ray or MRI; and we may need to talk to other specialists such as an orthopaedic shoulder surgeon, a radiologist, a neurologist, a sports doctor or a rheumatologist.

Shoulder instability treatment London

Physiotherapy for shoulder instability will focus on retraining the muscles and movement patterns that control the shoulder, whether you’re at rest or challenging yourself.  This will include the local stabilisers which directly control the ball’s position in the socket (primarily the rotator cuff muscles, though you’ll find that I’m not a fan of wafting your arm around with a bit of theraband!) and also the global stabilisers which control the position of the socket, such as the serratus anterior and lower trapezius.

However, if the passive systems (bone, cartilage and ligament) are significantly compromised, then we may also need to involve some of the other professionals.  Teamwork is key to success in this situation if you’re to make the best possible recovery – but don’t forget that the most important member of the team is you!

Shoulder instability physio assessments are 90 minutes

Follow-up sessions if required are usually an hour – it’s important to me to be very thorough when it comes to slipped disc physiotherapy, as I want to be the last back physiotherapist you need.

Shoulder pain specialist physio - Client reviews

"Nell is one of the best physio in the UK. She has been treating my shoulder problem. Nell is an excellent physio who understands and feels your pain and will make sure that she fixes your body with care. Although through covid has been difficult for everyone, she has been doing a home visit to help with my shoulder pain. I can't recommend Nell enough she is Amazing. "
Suad Mahamed
"Nell did what other physios and osteos couldn't — fix my shoulder, which had been sitting in the wrong place for about 15 years! If you have any doubt about booking with Nell, just do it — she's worth every penny."
Bryony
"My appointment with Nell was an absolute delight! She is thorough, detailed, hugely knowlegable, effective and has a brilliant manner. I walked out of the appointment with my shoulder pain gone in a single session, feeling very relaxed and with advice on how to manage any reoccurring issues. She came highly recommended by friends and I would not hesitate to return to her for any physio needs in the future."
Chantal Younis

Shoulder instability blog

As a leading Shoulder instability physiotherapist in London, I regularly write about injuries, treatment and assessment techniques.

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