Shoulder Instability in Rugby Players
Authors: Brendan Fourie & Lennard Funk
References: Presented at the International Sports Science & Sports Medicine Conference 2009
Introduction: The shoulder is frequently injured in collision sports, and up to 42% of all shoulder injuries sustained by rugby players involve the labrum.
Methods: A review of the results of the management of rugby players with instability treated by a single surgeon over a three year period (2005-2008) was performed. Data was collated from operative records, clinic notes and by telephoning players and physio therapists.
Results: 112 rugby players (including one female) underwent primary arthroscopic treatment for labral injury associated with instability. The age range was 15-40 (mean of 28) years old. 68 patients played rugby league whilst the remainder played rugby union. 80 were professional athletes, 5 semi-professional and 24 amateur (3 unknown). Analysis of the injury patterns by player position demonstrated injuries to anterior labrum of 30% in backs versus 46% in forwards. The incidence of associated SLAP tears was higher in backs (26% versus 15%). No difference was noted in injury pattern in relationship to age. The average time to return to play was 3.9 (2-8) months. There was no difference in the time to return to play for forwards and backs (4 vs. 3.8 months) nor on review of all the different injury patterns. 37% of operations did occur out of season. Time to return to play was on average longest in this group at 4.2 months. Players over 30 yrs of age took on average 4.8 months to return to sport. Overall constant scores improved from 53.6 to 89 points at three months and overall satisfaction was rated at 78%.
Conclusions: The high energy injuries sustained by these collision athletes often results in complex labral pathology. However the timing of surgery and age of the patients affect the return time to sport not injury pattern or player position.