Shoulder Multidirectional Instability

Multidirectional instability of the shoulder results from excessive glenohumeral joint laxity across multiple planes. Incidence ranges from 5% to 15%, peaking around age 15 in girls. Diagnosis relies on history and physical exam findings and presents most often in young athletes engaged in high-risk sports. First line treatment follows a conservative approach, with surgical options reserved for refractory cases. Conservative treatment, emphasizing shoulder and periscapular strengthening, along with proprioceptive training, can effectively manage most cases. Surgical intervention may be considered after 9–12 months of failed conservative therapy and typically includes capsular plication and labral augmentation. Challenges in management of multidirectional instability include determining optimal timing for surgery (when needed) and managing patient expectations, especially regarding return to competitive sports.