TY - JOUR
T1 - The challenge of the sporting shoulder
T2 - From injury prevention through sport-specific rehabilitation toward return to play
AU - Cools, Ann M.
AU - Maenhout, Annelies G.
AU - Vanderstukken, Fran
AU - Declève, Philippe
AU - Johansson, Fredrik R.
AU - Borms, Dorien
N1 - Publisher Copyright:
© 2020 Elsevier Masson SAS
PY - 2021/7
Y1 - 2021/7
N2 - Shoulder injuries and sports-related shoulder pain are substantial burdens for athletes performing a shoulder loading sport. The burden of shoulder problems in the athletic population highlights the need for prevention strategies, effective rehabilitation programs, and a individually based return-to-play (RTP) decision. The purpose of this clinical commentary is to discuss each of these 3 challenges in the sporting shoulder, to assist the professional in: (1) preventing injury; (2) providing evidence-based practice rehabilitation and; (3) to guide the athlete toward RTP. The challenges for injury prevention may be found in the search for (the interaction between) relevant risk factors, develop valid screening tests, and implement feasible injury prevention programmes with maximal adherence from the athletes. Combined analytical and functional testing seems mandatory screening an athlete's performance. Many questions arise when rehabilitating the overhead athlete, from exercise selection, over the value of stretching, toward kinetic chain implementation and progression to high performance training. Evidence-based practice should be driven by the available research, clinical expertise and the patient's expectations. Deciding when to return to sport after a shoulder injury is complex and multifactorial. The main concern in the RTP decision is to minimize the risk of re-injury. In the absence of a “gold standard”, clinicians may rely on general guidelines, based on expert opinion, regarding cutoff values for normal range of motion, strength and function, with attention to risk tolerance and load management.
AB - Shoulder injuries and sports-related shoulder pain are substantial burdens for athletes performing a shoulder loading sport. The burden of shoulder problems in the athletic population highlights the need for prevention strategies, effective rehabilitation programs, and a individually based return-to-play (RTP) decision. The purpose of this clinical commentary is to discuss each of these 3 challenges in the sporting shoulder, to assist the professional in: (1) preventing injury; (2) providing evidence-based practice rehabilitation and; (3) to guide the athlete toward RTP. The challenges for injury prevention may be found in the search for (the interaction between) relevant risk factors, develop valid screening tests, and implement feasible injury prevention programmes with maximal adherence from the athletes. Combined analytical and functional testing seems mandatory screening an athlete's performance. Many questions arise when rehabilitating the overhead athlete, from exercise selection, over the value of stretching, toward kinetic chain implementation and progression to high performance training. Evidence-based practice should be driven by the available research, clinical expertise and the patient's expectations. Deciding when to return to sport after a shoulder injury is complex and multifactorial. The main concern in the RTP decision is to minimize the risk of re-injury. In the absence of a “gold standard”, clinicians may rely on general guidelines, based on expert opinion, regarding cutoff values for normal range of motion, strength and function, with attention to risk tolerance and load management.
KW - Injury
KW - Prevention
KW - Rehabilitation
KW - Return-to-play
KW - Shoulder
KW - Sports
KW - Athletic Injuries/prevention & control
KW - Shoulder Injuries/prevention & control
KW - Humans
KW - Return to Sport
UR - http://www.scopus.com/inward/record.url?scp=85083877014&partnerID=8YFLogxK
U2 - 10.1016/j.rehab.2020.03.009
DO - 10.1016/j.rehab.2020.03.009
M3 - Review
C2 - 32320753
AN - SCOPUS:85083877014
SN - 1877-0657
VL - 64
SP - 101384
JO - Annals of Physical and Rehabilitation Medicine
JF - Annals of Physical and Rehabilitation Medicine
IS - 4
M1 - 101384
ER -