Return to Play after Glenohumeral Instability

OrthoMedia ◽  
2021 ◽  
2017 ◽  
Vol 45 (11) ◽  
pp. 2540-2546 ◽  
Author(s):  
Jonathan F. Dickens ◽  
John-Paul Rue ◽  
Kenneth L. Cameron ◽  
John M. Tokish ◽  
Karen Y. Peck ◽  
...  

Background: The debate continues regarding the optimal treatment of intercollegiate contact athletes with in-season anterior shoulder instability. Purpose: To examine return to sport and recurrent instability in the season after the index in-season anterior instability event. Study Design: Cohort study; Level of evidence, 2. Methods: Forty-five contact intercollegiate athletes treated nonoperatively or with arthroscopic stabilization were prospectively followed in a multicenter observational study to evaluate return to play (RTP) and recurrent instability in the season after an initial in-season anterior glenohumeral instability event. Baseline data collection included sport played, previous instability events, direction of instability, type of instability (subluxation or dislocation), and treatment method (nonoperative management or arthroscopic stabilization). All nonoperatively treated athletes underwent a standardized accelerated rehabilitation program without shoulder immobilization. Surgical stabilization was performed arthroscopically in all cases, and successful RTP was evaluated during the next competitive season after complete rehabilitation. Results: Thirty-nine of 45 intercollegiate contact athletes had remaining National Collegiate Athletic Association eligibility and were followed through the subsequent competitive season after the index instability event. Of the 10 athletes electing nonoperative treatment, 4 (40%) successfully returned to play without recurrence during the subsequent season. Of the 29 athletes treated surgically, 26 (90%) were able to successfully return to play without recurrence the following season (recurrence: n = 1; inadequate function: n = 2). Athletes who underwent surgical reconstruction before the next season were 5.8 times (95% CI, 1.77-18.97; P = .004) more likely to complete the subsequent season without recurrent instability. Of the 29 athletes electing surgical stabilization, there was no difference (risk ratio, 0.95; 95% CI, 0.10-9.24; P > .99) in RTP between the 9 stabilized after a single instability event (90% RTP rate) and the 20 stabilized after multiple in-season recurrent instability events (89% RTP rate). Conclusion: Collegiate contact and collision athletes with in-season anterior shoulder instability are significantly more likely to successfully return to sport without subsequent instability events the next season if they undergo surgical repair in the off-season.


2012 ◽  
Vol 13 (3) ◽  
pp. 70-78 ◽  
Author(s):  
Bess Sirmon-Taylor ◽  
Anthony P. Salvatore

Abstract Purpose: Federal regulations should be implemented to provide appropriate services for student-athletes who have sustained a concussion, which can result in impaired function in the academic setting. Eligibility guidelines for special education services do not specifically address the significant, but sometimes transient, impairments that can manifest after concussion, which occur in up to 10% of student-athletes. Method: We provide a definition of the word concussion and discuss the eligibility guidelines for traumatic brain injury and other health-impaired under IDEA, as is the use of Section 504. Results: The cognitive-linguistic and behavioral deficits that can occur after concussion can have a significant impact on academic function. We draw comparisons between the clinical presentation of concussion and the eligibility indicators in IDEA and Section 504. Conclusion: Speech-language pathologists are well-positioned to serve on concussion management teams in school settings, providing services including collection of baseline data, intervention and reassessment after a concussion has occurred, prevention education, and legislative advocacy. Until the cultural perception of concussion changes, with increased recognition of the potential consequences, student-athletes are at risk and appropriate implementation of the existing guidelines can assist in preservation of brain function, return to the classroom, and safe return to play.


1983 ◽  
Vol 2 (2) ◽  
pp. 319-338 ◽  
Author(s):  
Frederick A. Matsen ◽  
Joseph D. Zuckerman

2020 ◽  
Vol 15 (3) ◽  
pp. 421-428
Author(s):  
Brandon M. Schmitt ◽  
Timothy F. Tyler ◽  
Susan Y. Kwiecien ◽  
Michael B. Fox ◽  
Malachy P. McHugh

2020 ◽  
Author(s):  
Laura Rihani ◽  
Jennifer Usinger ◽  
Nicola Jungbäck ◽  
Gabriele Stumm ◽  
Thorsten Schulz ◽  
...  

BACKGROUND Sports-related mild traumatic brain injuries (sports related concussion, SRC) have received increasing attention since neurodegenerative processes have been linked to repetitive SRCs. Return-to-Play (RTP) rules have been established for medical advised return into sports activities after concussion, but it is not clear if these rules also reach the sports clubs and its young athletes. OBJECTIVE In youth sports, athletes and their parents search the internet for advice after SRC. We therefore investigated which websites of German sports associations and clubs in football (soccer), handball and rugby offer information on SRC and RTP rules. METHODS The systematic analysis included websites of local football, handball and rugby clubs in two comparable regions in Southern Bavaria and Lower Saxony. The websites of the regional and the German umbrella associations were also included into the study. Eight criteria of the revised Sport Concussion Consensus Statement served as standard for the evaluation according to the protocol published by Swallow et al. (J Neurosurg Pediatr, 2018). RESULTS No information on RTP rules or the topic “sports-related brain injuries” could be found on any of the clubs’ websites. Only the Bavarian Football Association and the Rugby Association sporadically provided information on the topic. The German umbrella associations in football and rugby take up international documents and regulations of the European and the world associations. No information could be found at the German Handball Association. CONCLUSIONS The topics of sports-related brain injuries and RTP rules are mostly neglected on the analysed Websites. This is remarkable, as there are clearly defined consensus guidelines which are widely accepted in international comparison. Especially in the USA, online information on this topic has become standard.


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