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<p>As a&#xa0;support for the humeral head, the scapula enables powerful and controlled movements in the shoulder joint. The interaction of the bony structures, static stabilization by capsule–ligament structures and dynamic stabilization by various muscle groups is essential. Changes or injuries to these structures can cause abnormal joint movement and position. Instabilities of the shoulder joint are often painful and lead to limited function of the upper extremity. It seems clear that the traumatic initial dislocation with typical structural defects must be differentiated from the generally atraumatic, involuntary instability. Changes in periscapular muscle function, e.g., due to incorrect innervation, hypo- or hypertonus or paresis, can lead to incorrect positioning of the scapula and ultimately shoulder instability, despite intact glenohumeral structures. Conservative measures (physiotherapy) should be initiated first and foremost. The accompanying use of electrical muscle stimulation (EMS, shoulder pacemaker) appears to be promising. Classic open and arthroscopic surgical techniques that address structural damage do not appear to be promising in cases of involuntary shoulder instability and the underlying pathology (“false muscle patterns”).</p>

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Funktionelle Schulterinstabilität – die Rolle der Skapula

  • 期刊论文

  • 发表日期：

    2025年1月20日

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  • Lisa Albrecht,
  • Svenja Haag,
  • Lars-Johannes Lehmann,
  • Philipp Moroder,
  • Christian Gerhardt

摘要

As a support for the humeral head, the scapula enables powerful and controlled movements in the shoulder joint. The interaction of the bony structures, static stabilization by capsule–ligament structures and dynamic stabilization by various muscle groups is essential. Changes or injuries to these structures can cause abnormal joint movement and position. Instabilities of the shoulder joint are often painful and lead to limited function of the upper extremity. It seems clear that the traumatic initial dislocation with typical structural defects must be differentiated from the generally atraumatic, involuntary instability. Changes in periscapular muscle function, e.g., due to incorrect innervation, hypo- or hypertonus or paresis, can lead to incorrect positioning of the scapula and ultimately shoulder instability, despite intact glenohumeral structures. Conservative measures (physiotherapy) should be initiated first and foremost. The accompanying use of electrical muscle stimulation (EMS, shoulder pacemaker) appears to be promising. Classic open and arthroscopic surgical techniques that address structural damage do not appear to be promising in cases of involuntary shoulder instability and the underlying pathology (“false muscle patterns”).