Characteristics of anterior shoulder instability and hyperlaxity in the weight-training population

Despite case reports implicating anterior instability (AI) as an etiological source of shoulder pain among weight-training (WT) participants, a paucity of case-controlled evidence exists to support this premise. The purpose of this study was to determine if WT participants have clinical characteristics of AI and hyperlaxity. Additionally, we investigated the role of exercise selection. One hundred fifty-nine healthy male participants (mean age 28 years) were recruited and included 123 individuals who engaged in WT a minimum of 2 days per week and 36 controls with no history of WT participation. Before testing, participants completed a questionnaire summarizing their training patterns. Upon completing the questionnaire, 3 reliable and valid tests used to identify clinical characteristics of AI were performed on both groups and included the load and shift, apprehension, and relocation maneuvers. Load and shift test results identified significantly greater anterior glenohumeral joint hyperlaxity in the WT group compared with controls (p = 0.004). The presence of positive apprehension (p < 0.001) and relocation (p < 0.001) tests were also significantly greater in the WT group. A significant association existed between performance of exercises that require the "high-five" position (behind-the-neck latissimus pull-downs and military press) and clinical characteristics of AI. Conversely, an inverse association between performance of external rotator strengthening and clinical characteristics of AI existed. Findings from this study suggest that individuals participating in WT may be predisposed to AI and hyperlaxity. Modification of exercises requiring the high-five position, as well as efforts to strengthen the external rotators, may serve as a useful means to mitigate characteristics associated with AI and hyperlaxity. Future intervention-based trials are needed to investigate a causative effect of exercises.