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Tackling Shoulder Instability in Football Players

Once a shoulder dislocates, there's a good chance it will do so again. This is called repeat shoulder instability. This condition is especially common among athletes who play contact or collision sports such as football.

What's the best way to prevent repeat shoulder instability in football players? Arthroscopic surgery, or surgery that uses special instruments to avoid making large incisions in the skin, may give less pain and better movement after surgery. However, football players who have this type of surgery often dislocate their shoulders again.

Doctors evaluated a standard "open" technique for football players with shoulder instability. Open procedures use larger incisions to expose the joint for surgery.

Fifty-eight football players had open surgery for repeat shoulder dislocations. Their average age was 18. After surgery, patients did at least four months of physical therapy to prepare them to return to sport.

Almost all of the patients returned to football for at least one year after surgery. Many of them played for two years or more. There were no complete dislocations after surgery. Two patients had partial dislocations. Most of the patients (84 percent) regained normal movement in the shoulder. None lost a significant amount of movement. About three years after surgery, 95 percent of patients had a good or excellent result.

Doctors feel that the open technique has several advantages over arthroscopic surgery for this group. With open surgery, doctors can see more of the joint. This allows them to restore needed tension in the shoulder by reinforcing damaged tissues. These steps help keep the shoulder strong.

Open surgery to stabilize the shoulder allows football players to return to sport with less risk of repeat dislocation. Most football players who have open surgery have good motion and function later. For this high-risk group, open surgery seems to work better than arthroscopy.

References: Michael J. Pagnani, MD, and David C. Dome, MD. Surgical Treatment of Traumatic Anterior Shoulder Instability in American Football Players. In The Journal of Bone and Joint Surgery. May 2002. Vol. 84-A. No. 5. Pp. 711-715.

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