Which shoulder motion combination should be avoided after recurrent dislocation?

Which shoulder motion combination should be avoided after recurrent dislocation?

• A. Adduction with internal rotation
• B. Abduction with external rotation
• C. Adduction with external rotation
• D. Abduction with internal rotation

Answer: (B)

In recurrent anterior shoulder instability, the position that most readily provokes dislocation is the combination of abduction and external rotation. This posture stretches and tensions the anterior capsule and the inferior glenohumeral ligament, and with damage to the anterior labrum (a Bankart lesion) the static restraints are compromised. As a result, the humeral head is more likely to move forward and out of the glenoid in this position, leading to dislocation or recurrent instability. That’s why this motion is avoided in rehab or protective activities after dislocation. The goal is to protect the healing structures and rely on dynamic stability from the rotator cuff and scapular stabilizers to keep the head centered, gradually restoring strength and control before reintroducing provocative positions. The other combinations are less likely to provoke anterior dislocation: they place the humeral head in less anteriorly stressed positions or do not tension the anterior restraints as strongly, so they are not as risky in the setting of recurrent instability.

In recurrent anterior shoulder instability, the position that most readily provokes dislocation is the combination of abduction and external rotation. This posture stretches and tensions the anterior capsule and the inferior glenohumeral ligament, and with damage to the anterior labrum (a Bankart lesion) the static restraints are compromised. As a result, the humeral head is more likely to move forward and out of the glenoid in this position, leading to dislocation or recurrent instability.

That’s why this motion is avoided in rehab or protective activities after dislocation. The goal is to protect the healing structures and rely on dynamic stability from the rotator cuff and scapular stabilizers to keep the head centered, gradually restoring strength and control before reintroducing provocative positions.

The other combinations are less likely to provoke anterior dislocation: they place the humeral head in less anteriorly stressed positions or do not tension the anterior restraints as strongly, so they are not as risky in the setting of recurrent instability.