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Return to rugby after a shoulder stabilisation in professional rugby players

Authors: DR Jones, L Funk, J Ross, I Horsley, L Herrington

References: Presented at the International Sports Science & Sports Medicine Conference 2009

Aims: Shoulder dislocation is not an uncommon injury in rugby. The majority of these progress to stabilisation surgery in order to return to play. Surgical techniques and rehabilitation programmes vary, but it is not truly known what the current practice and opinion is.
We undertook a survey of English premiership club physiotherapists attitudes towards rehabilitation after arthroscopic shoulder stabilisation surgery.

Methods: The lead physiotherapist at every club in the English premiership during the 2007-2008 season was selected to take part in a semi-structured telephone interview. The interview script was devised through an earlier focus group of leading clinicians in shoulder surgery and shoulder rehabilitation after surgery. The interviews were recorded and then analysed using interpretative phenomenological analysis (IPA).

Findings: The majority (83%) of physiotherapists were in agreement that an accelerated approach to rehabilitation was associated with better outcomes than a more traditional approach. Attitudes towards the practice of immobilisation of the shoulder after a surgical fixation varied significantly. Early mobilisation (1-2 weeks) was practiced using a target-based protocol, which was led by the therapist. Late mobilisation (3-6 weeks) was surgeon-led and time-based. Return to sport times ranged from three to six months. This correlated with the type of rehabilitation programme. Those players that were out of the sling earlier and began a graduated exercise program returned to rugby faster.

Conclusion: The rationale for and practice of shoulder immobilisation varied significantly as did the time at which the players return to rugby. This depended upon the rate of mobilisation and type of programme used.



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