Adam Rufa - 4/7/2006

Question
MDI ( multidirectional instability )
Followup To
Question -
I have MDI and I have been in and out of physical therapy. I have seen 3 or 4 different specialists and they keep telling me the same thing. They tell me that there really isn't anything that they can do. I was told that surgery wasn't an option because I was born with this condition and after i healed from surgery and did the therapy it would just come back again. Now I have a lot of joints that are slipping in and out. I want to know if you know of a place that i can go to where they have the best physicians that can help me. Im only 22 and I was told that i'd be lucky if I wasn't in a wheelchair by that time im 30. I have a 2 year old son that I have to think about. Now if you know something or know of someone  or even know of a place that I could contact to get some information that would help greatly  thank you,  
 Khristina
Answer -
By MDI do you mean multi-directional instability or something else. There are a few things that MDI can stand for.  

Answer
From what you are describing it sounds more than just MDI which is normally a term used to describe shoulder instability. Shoulder instability can occur for many reasons. Some people have traumatic dislocation of their shoulders, other people just have lose shoulder joints. People who use their arms over head can develop instability (baseball pitcher, swimmer) but that is often in one plane of the shoulder and is not multidirectional. From your description it sounds like you have global hypermobility (many different joints). This can be associated with syndromes such as Marfans syndrome. (http://www.marfan.org/nmf/index.jsp)
Unfortunately, too much motion at a joint can be very difficult to treat. It is often much easier to treat joints that do not move enough. When a joint moves too much there are two main things PT can do.

     1. Increase muscle strength around the joint. This does not always work! However, some PTs are better at this than others.
     2. Get any joints near the lose joint moving more. Sounds like you don't have any stiff joints in your body so that won't work well.

The surgeons may be right about you just loosening back up after surgery. The two most common reasons surgery for MDI fail are 1- they make it too stiff, 2- it loosens back up.
I don't know of any specialists that can help you. I did provide a link above for the national marfan foundation. There is a way to find a Dr in your area on that site. Even if you do not have marfans they should be used to dealing with patients who have very lose joints and they may be able to help you. Unfortunately, if PT did not help and surgeons won't touch you, your options are limited.


Good luck and if I can help you in any other way please let me know.

Adam
http://www.squidoo.com/lensmaster/workshop/physicaltherapy