Development and kinesitherapeutic treatment of glenhumeral instability

The upright position of a person frees the upper limb to perform precise activities. As a result, the arm can be placed at any point in an almost complete circle with a diameter determined by the length of the upper limb. This predetermines the development of mobility in the shoulder kinematic complex. However, the large volume of movement causes a compromise with stability, which is a prerequisite for the complex’s fragility. The shoulder joint can be luxated much more often than other joints due to the shallow joint fossa, and low congruence and bone stabilization. The main passive stabilizing structures are the fibrous joint capsule and ligaments, and the main dynamic stabilizer is the rotator cuff of the joint, which surrounds it on all sides. Therefore, the emphasis in kinesiotherapy is on restoring its function (4). The dislocation of the upper limb also has a significant social aspect, associated with job loss, financial difficulties, changes in the lifestyle of the individual and their family, etc. Unfortunately, there are no exact data on the loss of labor, cash benefits and loss in production, both in the world and in Bulgaria. Treatment of traumatic dislocation can be conservative, through adjustment and immobilization. If it fails and the subluxations become chronic, the patient is examined by magnetic resonance imaging and arthroscopy for surgical treatment. Surgical treatment of shoulder instability has been a problem that has attracted the attention of doctors since ancient times. Hippocrates was the first to pay serious attention to recurrent luxation and offer a technique for its treatment. In such patients, he caused burns with white-hot metal rods in several places around the joint in order to obtain coalescence that stabilized it. Restoration of anterior glenohumeral stabilization by the arthroscopic method is one of the most modern methods of treatment (1).