Recurring Shoulder Instability Injuries Likely Among Young Athletes Playing Contact Sports

Post provided by The American Academy of Orthopaedic Surgeons

Summer is a peak season for many sports, and with that comes sport-related injuries. Among those injuries is shoulder joint dislocation. According to a literature review in the August 2012 issue of the Journal of the American Academy of Orthopaedic Surgeons, most incidences of shoulder joint instability are the result of traumatic contact injuries like force or falling on an outstretched arm; a direct blow to the shoulder area; forceful throwing, lifting or hitting; or contact with another player.

• In 45 percent of shoulder joint instability injuries, young athletes lost more than 10 days from sport.
• Young male athletes are at greatest risk of shoulder joint instability injuries and recurrences.
• In one study, the rate of athletes reinjuring their shoulder was higher in patients younger than 23 years of age.
• Young athletes between the ages of 15 to 20 years of age who were treated nonsurgically had an injury recurrence rate of 87 percent.
• Arthritis of the shoulder occurred in up to 40 percent of athletes with recurring shoulder instability injuries.

Symptoms of shoulder joint dislocation include: pain, often severe; instability and weakness in the shoulder area; inability to move the shoulder; swelling; bruising; abnormal contouring of the shoulder; and numbness and tingling around the shoulder or in the arm or fingers.

Nonsurgical management includes:

• Brief shoulder immobilization and early rehabilitation.
• Motion-restricting braces or sleeves that prevent extreme overhead motion may be helpful in preventing recurring injuries among nonthrowing athletes, but can potentially limit function and level of play.
• Although rehabilitation may help some athletes return to sport within three weeks after an initial injury, there is a greater risk of shoulder joint instability recurring with early return to sport.

Surgical management includes:

• Recurrent shoulder joint instability or an inability to safely perform sport-specific drills despite rehabilitation, activity modification, or bracing are indications that surgical management options need to be considered.
• Early surgical stabilization removes the athlete from the competitive season and typically with unrestricted return to sport in six to nine months.
• Athletes with bone loss, recurrent instability, an instability event that occurs at the end of the season, or an inability to perform sport-specific drills are candidates for surgical stabilization.

Minimize the chances of shoulder dislocation:

• Strength- the shoulder relies on strong tendons and muscles to keep it stable. Keeping these muscles strong can relieve shoulder pain and prevent further injury.
• Flexibility- stretching the shoulder muscles is important for restoring range of motion and preventing injury. Gently stretching after strenghening exercises can help reduce muslce soreness and keep muscles long and flexible.