Winning combination for sports-related shoulder injuries

Researchers from the University of Adelaide spent three years analyzing evidence from 3,600 existing studies and concluded that a tailored exercise program starting three to six weeks after surgery is the best approach to preventing a secondary shoulder dislocation.

“Patients who dislocate their shoulder are at high risk of doing so again within six months, and may suffer from recurrent instability,” says Dr Timothy Lathlean from the University of Adelaide, an Accredited Exercise Physiologist (AEP) and postdoctoral researcher at the University of Adelaide. Adelaide Medical School and the South Australian Health and Medical Research Institute (SAHMRI).

“Our analysis found that those who began a robust exercise program after surgery were twice as likely to avoid a recurrent injury than those who only exercised to recover from their injury.”

The researchers found that starting a multimodal program — a combination of exercises aimed at strength, coordination, balance and muscle control — shortly after surgery produced better results than standard care programs that rely solely on strength training.

The review focused on patients who were experiencing first-time shoulder dislocations that occurred in an anterior direction as a result of a direct blow to the shoulder. This type of injury often occurs during sports or work accidents.

Shoulder dislocations are especially common in young men between the ages of 16 and 30, because they more often practice contact sports and perform physically challenging professions.

“Shoulder dislocation can be disabling and is often accompanied by weakness, stiffness, pain and inability to participate in daily activities and sports,” said Dr. Lathlean.

“People who have suffered this injury may have difficulty returning to work or exercise and there is an associated economic burden. This can be reduced with more effective treatment and timely, targeted rehabilitation.”

This research was part of a collaborative project with a PhD student at the Texas Tech University Health Sciences Center and the University of Adelaide’s School of Allied Health.

The findings have been published in the British Journal of Sports Medicine and could help both practitioners and researchers achieve the best outcomes from surgery and rehabilitation.

“The results show that there is a real need for more advanced exercise programs in the rehabilitation phase to improve outcomes for patients and get them back to exercise faster,” said Dr Lathlean.

“Similar approaches are already common in recovery from other types of surgery for spine or knee-related injuries and the evidence from this study shows that this would also be beneficial for patients with acute shoulder injuries.”