n International SportMed Journal - Recurrent shoulder instability in athletes : evaluation and management : review article




Recurrent shoulder instability is relatively common among male and female athletes. Instability results when there is a symptomatic loss of the ability to control glenohumeral motions during functional activities. The pathogenesis typically involves dysfunction of the static (osseous and capsulolabral) and/or dynamic (scapulothoracic and rotator cuff musculature) stabilising structures resulting from repetitive microtrauma. Manifestations may include apprehension, weakness, fatigue, reduced performance, and pain from secondary impingement. Shoulder instability is classified according to aetiology, onset, direction and degree. Successful treatment is predicated upon a complete history, physical examination, and appropriate diagnostic testing. Non-operative management is typically warranted for 3-6 months and focuses upon activity modification, postural correction, restoration of normal shoulder mechanics, strength-endurance training of the shoulder girdle musculature, and optimisation of neuromuscular control. Although non-operative treatment is successful in many cases, surgery may be warranted in refractory cases. In the appropriately selected athlete, satisfactory results can be obtained utilising either open or arthroscopic surgical techniques.


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