Recurrent Instability Seen in Intercollegiate Athletes With Shoulder Injury After Return to Play

SEATTLE—Among mid-season contact athletes with shoulder instability, 73% of athletes return to play after 1 week, according to a study presented at the 2014 Annual Meeting of the American Orthopaedic Society for Sports Medicine. Regardless of whether the initial injury was a subluxation or dislocation, 63% of the cases developed recurrent instability.

There is no consensus on the optimal treatment of young in-season athletes with anterior shoulder instability and limited data are available to guide return to play and treatment. MAJ Jonathan F. Dickens, MD, from the John A. Feagin Jr. Sports Medicine Fellowship and Keller Army Hospital in West Point, New York, and colleagues conducted a study to examine the likelihood of return to sport following an in-season shoulder instability event based on the type of instability (subluxation vs. dislocation). Additionally, injury factors and patient reported outcome scores administered at the time of injury were evaluated to assess the predictability of eventual successful return to sport and time to return to sport during the competitive season following injury.

Dr. Dickens and colleagues examined 45 male and female intercollegiate athletes over 2 academic years, to assess return to play following in-season anterior glenohumeral instability. Athletes included in the sample were both male and female and participated in sports including basketball, soccer, lacrosse, and football. All observed athletes underwent a standardized accelerated rehabilitation program without shoulder immobilization, following the initial shoulder instability event. Subjects were followed during the course of their competitive season to determine return to play success and recurrent instability.

Of the 45 athletes who suffered an anterior shoulder instability event, 33 (73%) returned to play for at least part of the season after a median 5 days lost from competition. “While a large portion of the athletes in this observational study return to mid-season sport, only 36% completed the season without subsequent instability,” said Dr. Dickens. Athletes with a subluxation injury (partial dislocation) of the shoulder were 5.3 times more likely to return in the same season compared to those with a complete dislocation. The most common reason for athletes not returning was the inability to reach sufficient shoulder function for athletic participation.

“These early results should be valuable to physicians caring for the in-season athlete with shoulder instability, as we have not yet reached a consensus treatment approach on these injuries,” said Dr. Dickens. “More research is needed to determine the effect of multiple recurrent instability events on long-term outcomes and this study will hopefully be a first good step in understanding this relationship.”

SEATTLE—Among mid-season contact athletes with shoulder instability, 73% of athletes return to play after 1 week, according to a study presented at the 2014 Annual Meeting of the American Orthopaedic Society for Sports Medicine. Regardless of whether the initial injury was a subluxation or dislocation, 63% of the cases developed recurrent instability.

There is no consensus on the optimal treatment of young in-season athletes with anterior shoulder instability and limited data are available to guide return to play and treatment. MAJ Jonathan F. Dickens, MD, from the John A. Feagin Jr. Sports Medicine Fellowship and Keller Army Hospital in West Point, New York, and colleagues conducted a study to examine the likelihood of return to sport following an in-season shoulder instability event based on the type of instability (subluxation vs. dislocation). Additionally, injury factors and patient reported outcome scores administered at the time of injury were evaluated to assess the predictability of eventual successful return to sport and time to return to sport during the competitive season following injury.

Dr. Dickens and colleagues examined 45 male and female intercollegiate athletes over 2 academic years, to assess return to play following in-season anterior glenohumeral instability. Athletes included in the sample were both male and female and participated in sports including basketball, soccer, lacrosse, and football. All observed athletes underwent a standardized accelerated rehabilitation program without shoulder immobilization, following the initial shoulder instability event. Subjects were followed during the course of their competitive season to determine return to play success and recurrent instability.

Of the 45 athletes who suffered an anterior shoulder instability event, 33 (73%) returned to play for at least part of the season after a median 5 days lost from competition. “While a large portion of the athletes in this observational study return to mid-season sport, only 36% completed the season without subsequent instability,” said Dr. Dickens. Athletes with a subluxation injury (partial dislocation) of the shoulder were 5.3 times more likely to return in the same season compared to those with a complete dislocation. The most common reason for athletes not returning was the inability to reach sufficient shoulder function for athletic participation.

“These early results should be valuable to physicians caring for the in-season athlete with shoulder instability, as we have not yet reached a consensus treatment approach on these injuries,” said Dr. Dickens. “More research is needed to determine the effect of multiple recurrent instability events on long-term outcomes and this study will hopefully be a first good step in understanding this relationship.”

SEATTLE—Among mid-season contact athletes with shoulder instability, 73% of athletes return to play after 1 week, according to a study presented at the 2014 Annual Meeting of the American Orthopaedic Society for Sports Medicine. Regardless of whether the initial injury was a subluxation or dislocation, 63% of the cases developed recurrent instability.

There is no consensus on the optimal treatment of young in-season athletes with anterior shoulder instability and limited data are available to guide return to play and treatment. MAJ Jonathan F. Dickens, MD, from the John A. Feagin Jr. Sports Medicine Fellowship and Keller Army Hospital in West Point, New York, and colleagues conducted a study to examine the likelihood of return to sport following an in-season shoulder instability event based on the type of instability (subluxation vs. dislocation). Additionally, injury factors and patient reported outcome scores administered at the time of injury were evaluated to assess the predictability of eventual successful return to sport and time to return to sport during the competitive season following injury.

Dr. Dickens and colleagues examined 45 male and female intercollegiate athletes over 2 academic years, to assess return to play following in-season anterior glenohumeral instability. Athletes included in the sample were both male and female and participated in sports including basketball, soccer, lacrosse, and football. All observed athletes underwent a standardized accelerated rehabilitation program without shoulder immobilization, following the initial shoulder instability event. Subjects were followed during the course of their competitive season to determine return to play success and recurrent instability.

Of the 45 athletes who suffered an anterior shoulder instability event, 33 (73%) returned to play for at least part of the season after a median 5 days lost from competition. “While a large portion of the athletes in this observational study return to mid-season sport, only 36% completed the season without subsequent instability,” said Dr. Dickens. Athletes with a subluxation injury (partial dislocation) of the shoulder were 5.3 times more likely to return in the same season compared to those with a complete dislocation. The most common reason for athletes not returning was the inability to reach sufficient shoulder function for athletic participation.

“These early results should be valuable to physicians caring for the in-season athlete with shoulder instability, as we have not yet reached a consensus treatment approach on these injuries,” said Dr. Dickens. “More research is needed to determine the effect of multiple recurrent instability events on long-term outcomes and this study will hopefully be a first good step in understanding this relationship.”