Functional Assessment and Rehabilitation of Shoulder Proprioception for Glenohumeral Instability

in Journal of Sport Rehabilitation
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Following injury to the articular ligaments, disruption of mechanoreceptors results in partial deafferentation of the joint. This has been shown to inhibit normal neuromuscular joint stabilization, and it contributes to repetitive injuries and the progressive decline of the joint. Assessment of proprioception is valuable in identification of proprioceptive deficits and subsequent planning of the rehabilitation program. A shoulder rehabilitation program must address both the mechanical and sensory functions of articular structures by incorporating a proprioceptive training element within the normal protocol. The objective of proprioception rehabilitation is to enhance cognitive appreciation of the respective joint relative to position and movement, and to enhance muscular stabilization of the joint in the absence of structural restraints. If these objectives are properly addressed, the restoration of the proprioceptive mechanism will prevent further disability of the shoulder joint.

Paul A. Borsa and Susan P. Lephart are doctoral students in sports medicine/exercise physiology at the University of Pittsburgh. Scott M. Lephart is with the Department of Sports Medicine/Athletic Training and the Department of Orthopaedic Surgery, 104 Trees Hall, University of Pittsburgh, Pittsburgh, PA 15261. Mininder S. Kocher is with the Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA 02115. Direct correspondence to Scott M. Lephart.

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