Multidirectional shoulder instability typically occurs in patients (females more than males) with general ligamentous laxity (loose joints) participating in repetitive overhead shoulder activity such as throwing, hitting, and swimming. It is generally believed that through injury or repetitive activity, these already lax ligaments undergo some further stretching that impairs the position-sensory function of the ligaments and the proper recruitment of muscles to maintain stability of the shoulder joint with activity. The resulting decreased stability and increased motion of glenohumeral joint (shoulder joint) causes impingement of different structures in the shoulder and pain particularly with repetitive overhead activity. Gross instability such as dislocations are less common. With this type of multidirectional instability, the humerus may move in front of (anterior), below (inferior), or behind (posterior) the glenoid.
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