47 research outputs found
Treatment of glenohumeral instability in rugby players
Rugby is a high-impact collision sport, with
impact forces. Shoulder injuries are common and result
in the longest time off sport for any joint injury in rugby.
The most common injuries are to the glenohumeral joint
with varying degrees of instability. The degree of instability
can guide management. The three main types of instability
presentations are: (1) frank dislocation, (2) subluxations
and (3) subclinical instability with pain and clicking.
Understanding the exact mechanism of injury can guide
diagnosis with classical patterns of structural injuries. The
standard clinical examination in a large, muscular athlete
may be normal, so specific tests and techniques are needed
to unearth signs of pathology. Taking these factors into
consideration, along with the imaging, allows a treatment
strategy. However, patient and sport factors need to be also
considered, particularly the time of the season and stage
of sporting career. Surgery to repair the structural damage
should include all lesions found. In chronic, recurrent
dislocations with major structural lesions, reconstruction
procedures such as the Latarjet procedure yields better outcomes.
Rehabilitation should be safe, goal-driven and athlete-
specific. Return to sport is dependent on a number of
factors, driven by the healing process, sport requirements and extrinsic pressures