Skip to main content
SpringerLink
Log in
SpringerLink
Log in

Shoulder Injuries in Contact Athletes

  • Chapter
  • First Online:
Sports Injuries of the Shoulder

Abstract

Contact athletes are prone to musculoskeletal injuries due to the high-impact nature of their sports. Shoulder injuries are extremely common and one of the leading causes of play-time loss. Acromioclavicular joint injury, anterior instability, rotator cuff injury, clavicle fracture, and posterior instability represent most of the injuries about the shoulder. This chapter describes the epidemiology, mechanism of injury, pathoanatomy, clinical evaluation of the major shoulder injuries as well as management guidelines with various treatment options.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Rice SG, American Academy of Pediatrics Council on Sports M, Fitness. Medical conditions affecting sports participation. Pediatrics. 2008;121(4):841–8.

    Article  Google Scholar 

  2. Headey J, Brooks JH, Kemp SP. The epidemiology of shoulder injuries in English professional rugby union. Am J Sports Med. 2007;35(9):1537–43.

    Article  Google Scholar 

  3. Kaplan LD, Flanigan DC, Norwig J, Jost P, Bradley J. Prevalence and variance of shoulder injuries in elite collegiate football players. Am J Sports Med. 2005;33(8):1142–6.

    Article  Google Scholar 

  4. Crichton J, Jones DR, Funk L. Mechanisms of traumatic shoulder injury in elite rugby players. Br J Sports Med. 2012;46(7):538–42.

    Article  Google Scholar 

  5. Owens BD, Campbell SE, Cameron KL. Risk factors for posterior shoulder instability in young athletes. Am J Sports Med. 2013;41(11):2645–9.

    Article  Google Scholar 

  6. Provencher MT, LeClere LE, King S, McDonald LS, Frank RM, Mologne TS, et al. Posterior instability of the shoulder: diagnosis and management. Am J Sports Med. 2011;39(4):874–86.

    Article  Google Scholar 

  7. Tischer T, Salzmann GM, El-Azab H, Vogt S, Imhoff AB. Incidence of associated injuries with acute acromioclavicular joint dislocations types III through V. Am J Sports Med. 2009;37(1):136–9.

    Article  Google Scholar 

  8. Lanzi JT Jr, Chandler PJ, Cameron KL, Bader JM, Owens BD. Epidemiology of posterior glenohumeral instability in a young athletic population. Am J Sports Med. 2017;45(14):3315–21.

    Article  Google Scholar 

  9. Cameron KL, Duffey ML, DeBerardino TM, Stoneman PD, Jones CJ, Owens BD. Association of generalized joint hypermobility with a history of glenohumeral joint instability. J Athl Train. 2010;45(3):253–8.

    Article  Google Scholar 

  10. Beighton P, Solomon L, Soskolne CL. Articular mobility in an African population. Ann Rheum Dis. 1973;32(5):413–8.

    Article  CAS  Google Scholar 

  11. Nguyen V, Williams G, Rockwood C. Radiography of acromioclavicular dislocation and associated injuries. Crit Rev Diagn Imaging. 1991;32(3):191–228.

    CAS  PubMed  Google Scholar 

  12. Dragoo JL, Braun HJ, Bartlinski SE, Harris AH. Acromioclavicular joint injuries in National Collegiate Athletic Association football: data from the 2004-2005 through 2008-2009 National Collegiate Athletic Association Injury Surveillance System. Am J Sports Med. 2012;40(9):2066–71.

    Article  Google Scholar 

  13. Lynch TS, Saltzman MD, Ghodasra JH, Bilimoria KY, Bowen MK, Nuber GW. Acromioclavicular joint injuries in the National Football League: epidemiology and management. Am J Sports Med. 2013;41(12):2904–8.

    Article  Google Scholar 

  14. Marcheggiani Muccioli GM, Manning C, Wright P, Grassi A, Zaffagnini S, Funk L. Acromioclavicular joint reconstruction with the LARS ligament in professional versus non-professional athletes. Knee Surg Sports Traumatol Arthrosc. 2016;24(6):1961–7.

    Article  Google Scholar 

  15. Mouhsine E, Garofalo R, Crevoisier X, Farron A. Grade I and II acromioclavicular dislocations: results of conservative treatment. J Shoulder Elb Surg. 2003;12(6):599–602.

    Article  Google Scholar 

  16. Cohen SB, Towers JD, Bradley JP. Rotator cuff contusions of the shoulder in professional football players: epidemiology and magnetic resonance imaging findings. Am J Sports Med. 2007;35(3):442–7.

    Article  Google Scholar 

  17. Goldberg JA, Chan KY, Best JP, Bruce WJ, Walsh W, Parry W. Surgical management of large rotator cuff tears combined with instability in elite rugby football players. Br J Sports Med. 2003;37(2):179–81.

    Article  CAS  Google Scholar 

  18. Tambe A, Badge R, Funk L. Arthroscopic rotator cuff repair in elite rugby players. Int J Shoulder Surg. 2009;3(1):8–12.

    Article  Google Scholar 

  19. Engelsma Y, Willems WJ. Arthroscopic stabilization of posterior shoulder instability. Knee Surg Sports Traumatol Arthrosc. 2010;18(12):1762–6.

    Article  CAS  Google Scholar 

  20. Dickens JF, Owens BD, Cameron KL, Kilcoyne K, Allred CD, Svoboda SJ, et al. Return to play and recurrent instability after in-season anterior shoulder instability: a prospective multicenter study. Am J Sports Med. 2014;42(12):2842–50.

    Article  Google Scholar 

  21. Owens BD, Dickens JF, Kilcoyne KG, Rue JP. Management of mid-season traumatic anterior shoulder instability in athletes. J Am Acad Orthop Surg. 2012;20(8):518–26.

    Article  Google Scholar 

  22. McCarty EC, Ritchie P, Gill HS, McFarland EG. Shoulder instability: return to play. Clin Sports Med. 2004;23(3):335–51.

    Article  Google Scholar 

  23. Buss DD, Lynch GP, Meyer CP, Huber SM, Freehill MQ. Nonoperative management for in-season athletes with anterior shoulder instability. Am J Sports Med. 2004;32(6):1430–3.

    Article  Google Scholar 

  24. Bottoni CR, Wilckens JH, DeBerardino TM, D'Alleyrand JC, Rooney RC, Harpstrite JK, et al. A prospective, randomized evaluation of arthroscopic stabilization versus nonoperative treatment in patients with acute, traumatic, first-time shoulder dislocations. Am J Sports Med. 2002;30(4):576–80.

    Article  Google Scholar 

  25. Kim SH, Ha KI, Kim SH. Bankart repair in traumatic anterior shoulder instability: open versus arthroscopic technique. Arthroscopy. 2002;18(7):755–63.

    Article  Google Scholar 

  26. Potzl W, Witt KA, Hackenberg L, Marquardt B, Steinbeck J. Results of suture anchor repair of anteroinferior shoulder instability: a prospective clinical study of 85 shoulders. J Shoulder Elb Surg. 2003;12(4):322–6.

    Article  Google Scholar 

  27. Burkhart SS, De Beer JF. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion. Arthroscopy. 2000;16(7):677–94.

    Article  CAS  Google Scholar 

  28. Piasecki DP, Verma NN, Romeo AA, Levine WN, Bach BR Jr, Provencher MT. Glenoid bone deficiency in recurrent anterior shoulder instability: diagnosis and management. J Am Acad Orthop Surg. 2009;17(8):482–93.

    Article  Google Scholar 

  29. Porcellini G, Campi F, Paladini P. Arthroscopic approach to acute bony Bankart lesion. Arthroscopy. 2002;18(7):764–9.

    Article  Google Scholar 

  30. Shaha JS, Cook JB, Song DJ, Rowles DJ, Bottoni CR, Shaha SH, et al. Redefining “critical” bone loss in shoulder instability: functional outcomes worsen with “subcritical” bone loss. Am J Sports Med. 2015;43(7):1719–25.

    Article  Google Scholar 

  31. Yamamoto N, Muraki T, An KN, Sperling JW, Cofield RH, Itoi E, et al. The stabilizing mechanism of the Latarjet procedure: a cadaveric study. J Bone Joint Surg Am. 2013;95(15):1390–7.

    Article  Google Scholar 

  32. Gartsman GM, Waggenspack WN Jr, O'Connor DP, Elkousy HA, Edwards TB. Immediate and early complications of the open Latarjet procedure: a retrospective review of a large consecutive case series. J Shoulder Elb Surg. 2017;26(1):68–72.

    Article  Google Scholar 

  33. Griesser MJ, Harris JD, McCoy BW, Hussain WM, Jones MH, Bishop JY, et al. Complications and re-operations after Bristow-Latarjet shoulder stabilization: a systematic review. J Shoulder Elb Surg. 2013;22(2):286–92.

    Article  Google Scholar 

  34. Young AA, Maia R, Berhouet J, Walch G. Open Latarjet procedure for management of bone loss in anterior instability of the glenohumeral joint. J Shoulder Elb Surg. 2011;20(2 Suppl):S61–9.

    Article  Google Scholar 

  35. Hovelius L, Sandstrom B, Saebo M. One hundred eighteen Bristow-Latarjet repairs for recurrent anterior dislocation of the shoulder prospectively followed for fifteen years: study II-the evolution of dislocation arthropathy. J Shoulder Elb Surg. 2006;15(3):279–89.

    Article  Google Scholar 

  36. Yamamoto N, Itoi E, Abe H, Minagawa H, Seki N, Shimada Y, et al. Contact between the glenoid and the humeral head in abduction, external rotation, and horizontal extension: a new concept of glenoid track. J Shoulder Elb Surg. 2007;16(5):649–56.

    Article  Google Scholar 

  37. Di Giacomo G, Itoi E, Burkhart SS. Evolving concept of bipolar bone loss and the Hill-Sachs lesion: from “engaging/non-engaging” lesion to “on-track/off-track” lesion. Arthroscopy. 2014;30(1):90–8.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea

    Sungjoon Lim & Lennard Funk

  2. Upper Limb Unit, Wrightington Hospital, Wigan, UK

    Lennard Funk

Authors
  1. Sungjoon Lim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lennard Funk
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Wrightington Hospital, Wigan, UK

    Lennard Funk

  2. Wrightington Hospital, Wigan, UK

    Mike Walton

  3. Wrightington Hospital, Materials, University of Manchester, Wigan, UK

    Adam Watts

  4. Upper Limb Unit, Wrightington Hospital, Wigan, UK

    Michael Hayton

  5. Upper Limb Unit, Wrightington Hospital, Wigan, UK

    Chye Yew Ng

Q&A

Q&A

  1. (1)

    What are the differences between contact and collision sports and does this differentiation important in studies of sports injuries of the shoulder?

    Answer: Collision sports involve intentional collisions with opponents, such as American Football and rugby. Contact sports involve inadvertent contact with opponents, such as basketball and soccer.

  2. (2)

    What are the most common contact sports shoulder injuries and how frequent are concomitant problems?

    Answer: The most common injuries are AC joint injuries, labral and rotator cuff injuries. Concomitant injuries are frequent, with 20% of AC joint injuries having an associated labral or cuff tear. Rotator cuff tears commonly are associated with a glenohumeral joint subluxation or dislocation in the collision/contact athlete.

  3. (3)

    Which ACJ injuries are best treated surgically?

    Answer: High grade injuries that are not settling in-season with a short period of rehabilitation and end of season injuries.

  4. (4)

    Is open stabilisation surgery still the gold standard operation for instability in the athletes’ shoulder?

    Answer: It has been superseded by arthroscopic procedures, but bony reconstructions are indicated when there is bone involvement.

  5. (5)

    How does the “glenoid track” concept aid decision making?

    Answer: The glenoid track is the contact area between the humeral head and glenoid in the position of abduction and external rotation. If this is reduced by glenoid bone loss and/or a large medial Hil-Sachs lesion then the risk of recurrence is very high.

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Lim, S., Funk, L. (2020). Shoulder Injuries in Contact Athletes. In: Funk, L., Walton, M., Watts, A., Hayton, M., Ng, C. (eds) Sports Injuries of the Shoulder. Springer, Cham. https://doi.org/10.1007/978-3-030-23029-6_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-23029-6_3

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-23028-9

  • Online ISBN: 978-3-030-23029-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation