Immediate Reduction Vital for Remote Shoulder Injuries
Extreme athletes who dislocate a shoulder must receive immediate reduction. Clinical guidance presented at the International Extreme Sports Medicine Congress suggests that rapid assessment and reduction is critical.
The Case for On-Site Intervention
When a shoulder dislocates during activity, waiting for hospital transport is often impractical. Eric McCarty, MD, professor and chief of sports medicine in shoulder surgery at University of Colorado School of Medicine, argues that reduction on-site is important.
“We have to identify the injury and the direction of the dislocation, and, if the shoulder dislocated during activity, we want to try to reduce it where we are,” McCarty stated during his presentation. Once the shoulder has been reduced, the athlete can be placed in a sling for comfort and begin rehabilitation.
Establishing Benchmarks for Return to Play
Clearing an athlete to return to sport is a decision based on sport-specific demands and the nature of the instability. McCarty stresses that clinicians must define the instability and the impact of the instability, while also weighing the injury’s timing within the season.
The ideal criteria for return to play includes little to no pain, near normal range of motion and normal strength, functional ability and sports specific skills.
Tailoring Surgical Strategy to the Athlete
Not everybody needs surgery, but recovery plans must be custom-built for the individual. If a first-time dislocation occurs in season, medical teams must determine if the athlete is able to return to sport. If shoulder instability affects the athlete’s ability to play, they should undergo surgical fixation in season. For others, surgery can be deferred. The approach must match the sport: a kayaker is going to be different than a snowboarder.
Balancing Stability with Long-Term Function
Effective management requires a balance between immediate reduction and long-term recovery. Physicians must prioritize early assessment and individualized treatment plans that reflect the unique physical demands of each discipline. The goal is to ensure athletes continue to be able to do what they do.