Decreasing Shoulder Instability Recovery Time with Stress Ultrasound

Published on Mar 10, 2016

Shoulder instability recovery time is a big deal because procedures to stabilize the shoulder typically cause major life disruption. What if there was a better way? What if by accurately measuring the amount of instability using ultrasound and then using your own platelets or stem cells we were able to help stabilize the shoulder without surgery?

When the shoulder becomes unstable, it’s important to be able to accurately measure the extent of the damage in order to properly treat the problem. It’s very difficult, if not impossible, to quantify the damage using an MRI because the MRI is a static image (it doesn’t move), and, obviously, instability is all about too much movement. Today, we’re going to be looking at using stress ultrasound imaging to measure shoulder instability that has too much forward motion in the joint.

First, let’s get familiar with shoulder anatomy and how instability can occur.

Shoulder Anatomy

Medical illustration of shoulder joint structure labeled

Alila Medical Media/Shutterstock

The shoulder is a shallow ball-and-socket joint. The ball is actually the ball-shaped head of the humerus bone (the long bone in the upper arm), and the socket is a shallow depression (called the glenoid cavity) in the shoulder blade. This ball and socket in these two bones fit together to form the shoulder joint. There are ligaments that hold the shoulder in place, providing stability as well as movement, and problems with the ligaments can affect the whole shoulder.

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How Shoulder Instability Occurs

The ligaments that hold the shoulder in place can get loose and become unstable due to a variety of reasons, such as trauma causing dislocation, degeneration of the joint as you age, or just wear and tear and how your body is built. When the ligaments get loose, the shoulder can move too far forward (what we are looking at for this article) or too far backward. This extra movement is shoulder instability.

Why The Need For Shoulder Instability Recovery Time?

The most common way to stabilize the shoulder is through surgery. The procedure usually sews the torn ligaments and other structures together. However, this means huge downtime and lots of shoulder instability recovery time. Is there a better way?

How Stress Shoulder Ultrasound Works

The first key to helping the shoulder recover without surgery is the ability to accurately measure instability and progress. How does that work?

The first thing I do when using stress ultrasound imaging on an unstable shoulder joint is stress the joint. I do this by holding one hand on the backside of the joint to keep the socket stable. I then push forward on the ball of the joint using my other hand. The ultrasound probe is positioned to get a look at what’s happening with the stability at the front of the shoulder as I push forward, and it allows me to measure any motion that exists. In the short video below, you will see a side-by-side comparison of a stable joint (nothing significant happens when I push on the ball of the joint) and an unstable joint (significant movement is observed when I push on the ball of the joint).

Non-surgical Shoulder Instability Treatment?

We can usually fix the instability without the need for shoulder instability recovery time with precise ultrasound-guided platelet rich plasma injections. When it’s really severe, we can stabilize the area with stem cells. We will then track the progress of the treatment via subsequent stress ultrasound studies.

The upshot? An MRI can’t provide accurate information for the proper measurement of shoulder instability. Using stress ultrasound imaging to measure shoulder instability is a better option due to its ability to capture movement during the test. Surgery isn’t typically needed for shoulder instability. Platelet rich plasma, or stem cells can usually stabilize the joint, and then following up periodically with stress ultrasound studies in the office is a very nice metric to see if the shoulder is actually getting better over time.