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Question
Posted by: rosie | 2005/05/20

Shoulder surgery - how long till i can play rugby?!

Hi, I play rugby and repeatedly subluxate or dislocate my shoudler when playing. I initially dislocated it playing rugby about 2 years ago (when i was 20), and it took about 4 hours till it was put back in at the hospital under general anaesthetic (it was a Sunday; apparently doctors don't go in to hospital on sundays in belgium...;) )
I now have general discomfort a lot of the time, though it is obviously worse when i have specifically injured my shoulder. I want to carry on playing rugby but at the moment it seems unrealistic as my shoulder is so prone to injury - it seems to me that surgery might be the best option now. How long would it be after an op till I could realistically start training/playing full-contact again? Will I have to be referred by my GP? I miss playing!! Thanks very much, Rosie

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Our expert says:
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You are not being very clear about your injury and whether you received any rehabilitation type treatment for your shoulder. Since an anterior shoulder dislocation (dislocation of the shoulder to the front) is the most common shoulder dislocation injury, I’ll assume that it’s what you had.

Most anterior dislocations damage the anterior glenoid margin (called a Bankart lesion). There may also be an associated fracture of the anterior glenoid rim or disruption of the antero-glenohumeral ligaments (ligaments attaching the humerus, or upper arm, to the shoulder blade). A compression fracture of the humeral head posteriorly (Hill-Sachs lesion) or tearing of the posterior structures may also be present. Anterior dislocations are occasionally associated with damage to the axillary nerve, resulting in impaired sensation on the lateral or the outside aspect of the shoulder.

Shoulder dislocations in young athletes like yourself, have a high incidence of recurrence leading to chronic shoulder instability. Because of this high incidence of recurrent dislocation, an arthroscopy should be considered. If a Bankart lesion is found at arthroscopy, this should be repaired surgically.

Whether you go for the surgery or not, I highly recommend you going to a biokineticist for a full shoulder assessment. This assessment will help identify any anatomical or biomechanical deficits that exist due to the injury and surgical procedure. This assessment would include and identify the flexibility of certain shoulder muscles, muscle strength imbalances, and the function of very important stabilizing muscles. Finally, distant deficits that might contribute to shoulder abnormalities should be evaluated as well. These deficits may include postural alterations, back and hip flexibility, hip stability, and alterations in biomechanics.

Regardless of the time to full recovery after a surgical procedure, I highly recommend you going through a full and intensive rehabilitation process, since this will ensure that you regain full function of your shoulder. The following is a very rough guideline and timeframe to surgical vs. non-surgical treatment:

Surgical Treatment:
Week 1-6: Protection Phase
Week 6-12: Intermediate Phase
Week 12-20: Advanced activity & strengthening phase
Week 20-29: Return to Activity Phase

Non-surgical Treatment:
Week 1-3: Immobilization phase
Week 3-8: Return to Active Range of Motion
Week 6-12: strengthening phase & restoring neuromuscular control
Week12-20:Functional Progression Phase
Week 20-26: Return to Activity Phase

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

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Posted by: tk | 2005/08/02

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