In this section
Check for anterior apprehension. With the shoulder abducted and externally rotated, push gently from the posterior aspect of the proximal humerus and watch patient for discomfort.
If acute and reduced, sling for comfort and commence physiotherapy.
Whilst risk of re-dislocation is very high in young patients, most patients are suitable for a course of physiotherapy, aimed at regaining range of motion and strengthening dynamic muscle stabilisers to prevent further instability episodes.
Multi-directional instability (MDI) is common in young adolescents, particularly females, and may not have initially a traumatic episode. Symptoms can be vague. Patients can complain more about pain than actual instability episodes. First line management is also physiotherapy.