Our 17 year-old-son is involved in weight lifting and wrestling. During one very challenging wrestling match, he dislocated his shoulder. I didn’t think a shoulder dislocation would occur in somethat that young and strong. Is this unusual?

The number of first-time shoulder dislocations in young, active athletes has gone up over time. Some of this may be because more people are involved in sports. But collision sports are also more vigorous (some say extreme) than in the past.

The structures around the shoulder (e.g., ligaments, capsule, muscles) are designed to prevent dislocations. But with enough force and with the shoulder in just the right position, these safeguards can be overcome.

Younger patients are more likely to end up with a labral tear. Injury in older adults is more common because of degenerative changes of the rotator cuff associated with aging. The labrum is a tough rim of cartilage around the shoulder socket. The rotator cuff is a group of four muscles and tendons that surround the shoulder.

Both of these anatomical structures help hold the shoulder stable and in place. A torn anterior-inferior (front/lower) labrum and joint capsule is called a Bankart lesion. Bankart lesions are very common in all anterior shoulder dislocations. A Bankart lesion reduces the depth of the shoulder socket by 50 per cent. Without the passive restraint mechanisms of the soft tissues, recurrent dislocation is possible and even probable.

Even military recruits in top shape are subject to shoulder dislocations. For young athletes and soldiers, the nature of the high physical demand on the shoulder is the real key to understanding how this injury can occur.