The Recognition and Treatment of First-Time Shoulder Dislocation in Active Individuals

Anterior shoulder dislocation occurs in the general population; however, the incidence is doubled in the young athletic population. Over 90% of shoulder dislocations are in the anterior direction. For the first-time dislocation, a systematic approach to evaluating the patient and prompt reduction are critical. This injury is frequently witnessed on the field or later in the emergency department. On the field, closed reductions, without prereduction radiographs, is controversial. If the athlete is encountered in the emergency department, radiographs should be obtained prior to a closed reduction. After a closed reduction is achieved, several factors, such as timing in the season, type of sport, position, and patient goals, must be considered when deciding whether further surgical intervention is required. Conservative management will usually consist of a brief period of immobilization in a sling, followed by rehabilitation. Surgical treatment consists of an arthroscopic Bankart repair. LEVEL OF EVIDENCE: Therapy, level 5. J Orthop Sports Phys Ther 2009; 39(2):118-123. doi:10.2519/jospt.2009.2804