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Return to play decision after shoulder dislocation in upper limb athletes: Critical analysis between the habits of medical professionals and the literature - 26/01/24

Doi : 10.1016/j.otsr.2023.103715 
Amandine Gofflot a, b, c, , Jean-Louis Croisier a, b, c, Jean-François Kaux a, b, François Delvaux a, b, c, François Tubez c, Camille Tooth a, c, Stephen Bornheim a, b, Bénédicte Forthomme a, b, c
a Department of Rehabilitation and Sports Sciences, University of Liege, Liege, Belgium 
b Department of Physical Medicine and Sports Traumatology, SportS2, FIFA Medical Center of Excellence, IOC Research Center for Prevention of Injury and Protection of Athlete Health, FIMS Collaborative Center of Sports Medicine, University and University Hospital of Liege, Liege, Belgium 
c Laboratory of Human Motion Analysis, University of Liege, Liege, Belgium 

Corresponding author. 2, allée des Sports, 4000 Liege, Belgium

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Abstract

Background

The return to field is a critical moment for an athlete who has dislocated his shoulder as there is a significant risk of recurrence. The decision to return to field made by the doctor will therefore be crucial for the smooth continuation of the athlete's career.

Hypothesis

This objective is to compare the criteria most used by specialists in clearing an overhead athlete to return to competition after a first episode of antero-internal dislocation of the glenohumeral joint with or without surgery and those mentioned in the literature.

Patients and methods

The target population consisted of French-speaking physicians in orthopedic surgery, physical medicine and rehabilitation or sports medicine. This study was conducted by the means of a questionnaire. The questionnaire was validated by three experts in sports medicine and published on an online survey website.

Results

Sixty-three medical specialists responded to the questionnaire. On average, they use more than nine criteria to decide if an athlete is fit to return to competition. Over the 12 criteria proposed, four are used by more than 90% of respondents: laxity/instability, pain, range of motion and patient's subjective feeling. The methods used to evaluate certain criteria such as pain, joint range or muscular strength are often subjective and very often not validated by the literature.

Conclusion

Doctors use a set of criteria to allow an overhead athlete to return to competition. This study highlights that the techniques employed to evaluate these criteria are not always thoroughly validated by literature reviews.

Level of evidence

III; observational study.

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Keywords : Shoulder dislocation, Athletic injuries, Return to sport


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Vol 110 - N° 1

Articolo 103715- febbraio 2024 Ritorno al numero
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