Management of mid-season traumatic anterior shoulder instability in athletes

J Am Acad Orthop Surg. 2012 Aug;20(8):518-26. doi: 10.5435/JAAOS-20-08-518.

Abstract

Shoulder dislocation and subluxation injuries are common in young athletes and most frequently occur during the competitive season. Controversy exists regarding optimal treatment of an athlete with an in-season shoulder dislocation, and limited data are available to guide treatment. Rehabilitation may facilitate return to sport within 3 weeks, but return is complicated by a moderate risk of recurrence. Bracing may reduce the risk of recurrence, but it restricts motion and may not be tolerated in patients who must complete certain sport-specific tasks such as throwing. Surgical management of shoulder dislocation or subluxation with arthroscopic or open Bankart repair reduces the rate of recurrence; however, the athlete is unable to participate in sport for the remainder of the competitive season. When selecting a management option, the clinician must consider the natural history of shoulder instability, pathologic changes noted on examination and imaging, sport- and position-specific demands, duration of treatment, and the athlete's motivation.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Arthroscopy
  • Athletic Injuries / physiopathology
  • Athletic Injuries / rehabilitation
  • Athletic Injuries / surgery
  • Athletic Injuries / therapy*
  • Braces*
  • Humans
  • Joint Instability / physiopathology
  • Joint Instability / rehabilitation
  • Joint Instability / surgery
  • Joint Instability / therapy*
  • Physical Examination
  • Physical Therapy Modalities
  • Range of Motion, Articular
  • Recurrence
  • Shoulder Injuries
  • Shoulder Joint* / physiopathology
  • Shoulder Joint* / surgery
  • Time Factors
  • Treatment Outcome