Diagnosed With Posterior Instability

Topic Title: Diagnosed With Posterior Instability
Created On: 06/27/2010 08:44 AM

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 06/27/2010 08:44 AM

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Looking for some advice on my latest shoulder diagnosis. Want to make sure that I'm doing everything possible to avoid surgery. For eight months now I've been dealing with posterior shoulder pain. Back in February, I had an MRI arthogram done and it revealed: * Small, partial tear of infraspinitas * Partial tear of two of the posterior glenohumeral ligaments * Labrum intact One ortho indicated I needed to do 4-6 weeks of rehab for the IN tear. Another indicated I had scapular diskinesis. BOTH ignored the glenohumeral ligament issues. So, I've done two stints of physical therapy since and my situation has worsened. Not only is my posterior shoulder pain still there, but I have developed "trigger points" in my teres minor, infraspinitas, and lats. I recently met with a new physical therapist and he gave me a very thorough, 2 hour evaluation. Most thorough evaluation to date. He thinks that I have a somewhat "loose shoulder." Reasons: * Posterior pain when "pressing" (i.e. bench press, push ups). * Posterior pain when reaching out directly in front of me with my right arm. For example, if I were to do a forward raise with a dumbell, I'd have pain when my fist is directly in front of me. (Not so when raising to this point and moving up past this point). * Apprehension during the supposed "apprehension test." Also, when I sleep on my right shoulder I feel like I have to "move it into place" to sleep comfortably. * I used to be an overhead pitcher in high school. * Atrophy in my supraspinitas, infraspinitas, deltoid. I'm starting 3-6 weeks of rehab starting tmrw. It's all about exercise, very little tissue work (and I've had tons of it with no relief). Some questions: 1. Does the above sound like an instability issue? I've never had a dislocation. 2. If yes, how likely will rehab help? 3. Are there any clear dos and donts in terms of treating an unstable shoulder? 4. Is there ANYTHING else I should investigate? On 4., I'm working on eight months of aggravation, multiple mis-diagnoses, and multiple failed rehab attempts. I just want to make sure I'm doing this all right. I think this is it. If this doesn't work I'll have to investigate surgical intervention. Thanks. Kevin

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