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The unstable shoulder in the adolescent athlete
Judie Walton1, Anastasios Paxinos, Anthony Tzannes
1Sports Medicine and Shoulder Service and the Orthopaedic Research Institute, St. George Hospital Campus, University of New South Wales, Sydney, Australia.
The American Journal of Sports Medicine
|September 20, 2002
Summary
Shoulder instability, common in athletes, often involves anterior dislocation and recurrence, especially in adolescents. Rehabilitation focuses on strengthening dynamic and proprioceptive restraints to prevent future shoulder instability.
Area of Science:
- Orthopedics
- Sports Medicine
- Biomechanics
Background:
- Shoulder dislocation and subluxation are prevalent in athletic populations, with peak incidence in the second and sixth decades of life.
- Anterior dislocations represent the majority of traumatic shoulder injuries.
- Recurrence is the most common complication, particularly in adolescent athletes, highlighting the need for effective management strategies.
Purpose of the Study:
- To define the dynamic (muscular) and static (capsuloligamentous and labral) restraints of the shoulder.
- To review recent advancements in surgical interventions for shoulder instability.
- To outline the goals of rehabilitation in managing shoulder instability.
Main Methods:
- Review of current literature on shoulder instability, focusing on anatomical restraints and surgical techniques.
- Analysis of rehabilitation principles aimed at improving dynamic and proprioceptive functions.
- Synthesis of findings to provide a comprehensive overview of shoulder instability management.
Main Results:
- The dynamic and static stabilizers of the shoulder are well-characterized.
- Current surgical approaches for shoulder instability are increasingly conservative, emphasizing the restoration of static restraints.
- Rehabilitation strategies are evolving to enhance muscular and proprioceptive control.
Conclusions:
- Understanding the biomechanics of shoulder instability is crucial for effective treatment.
- Minimally invasive surgical techniques are gaining prominence in addressing capsuloligamentous and labral disruptions.
- Rehabilitation plays a vital role in optimizing dynamic muscular support and proprioception to prevent recurrent shoulder instability.