Abstract

Shoulder instability is a common cause of morbidity amongst professional rugby players. This study explores whether the risk of shoulder dislocation is associated with innate shoulder laxity. We performed a pilot study where we validated techniques we used in the study and subsequently gained Ethics committee approval. The study was a prospective, randomised controlled study, in which we visited all the Premiership Rugby Clubs in England. We assessed 169 professional rugby players (mean age 25.1 years, range 18-35) with no history of instability in either shoulder and 46 injured players with one shoulder with clinical shoulder instability symptoms (male, mean age 27.5 years, range 20-33). We assessed shoulder laxity by means of clinical evaluation, questionnaires and ultrasound. We found there was no significant difference between left and right shoulders in healthy players (p lt 0.05). We found that players who had sustained an anterior dislocation, had increased anterior laxity of their normal shoulders, as measured by ultrasound, compared with those who had had no dislocations (p lt 0.05). These findings were not reproduced on clinical examination. There was no correlation between, the age of the player, dominant hand or position played and the incidence of increased laxity. This is the first study looking at laxity and the risk of shoulder dislocations in sportsmen involved in a high contact sport. These results support the hypothesis that rugby players with shoulders are more likely to sustain a dislocation or subluxation injury to one of these lax shoulders in their sport. We believe pre-season screening and targeted training may play a role in identifying those at risk and may decrease the incidence of dislocations.

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