Anterior shoulder instability in weight lifters

Occult instability is recognized as a major cause of shoulder dysfunction in throwing athletes. Few studies have characterized the findings of occult instability in nonthrowers. The purpose of this study was to examine shoulder instability in a group of weight lifters. The symptoms, physical findings, and results of treatment for 23 shoulders in 20 athletes are presented. All athletes presented with a complaint of progressive inability to perform exercises with the upper extremity in the abducted, externally rotated position (the "at-risk" position) because of pain. One hundred percent of the athletes experienced posterior shoulder pain when the shoulder was placed in forced abduction and external rotation. Thirteen shoulders in 10 patients responded to conservative management including aggressive rehabilitation and modification of technique to avoid the at-risk position. The other 10 shoulders, which did not respond to conservative treatment, required surgical treatment to alleviate the symptoms. All 20 patients have successfully returned to their previous weight lifting activities.