Return to play decision after shoulder dislocation in upper limb athletes: critical analysis between the habits of medical professionals and the literature.

BACKROUND: The return to field is a critical moment for an athlete who has dislocated his shoulder as there is a significant risk of recurrence. The decision to return to field made by the doctor will therefore be crucial for the smooth continuation of the athlete's career.

HYPOTHESIS: This objective is to compare the criteria most used by specialists in clearing an overhead athlete to return to competition after a first episode of antero-internal dislocation of the glenohumeral joint with or without surgery and those mentioned in the literature.

PATIENTS AND METHODS: The target population consisted of French-speaking physicians in orthopaedic surgery, physical medicine and rehabilitation or sports medicine. This study was conducted by the means of a questionnaire. The questionnaire was validated by 3 experts in sports medicine and published on an online survey website.

RESULTS: Sixty-three medical specialists responded to the questionnaire. On average, they use more than 9 criteria to decide if an athlete is fit to return to competition. Over the 12 criteria proposed, 4 are used by more than 90% of respondents: laxity/instability, pain, range of motion and patient's subjective feeling. The methods used to evaluate certain criteria such as pain, joint range or muscular strength are often subjective and very often not validated by the literature.

CONCLUSION: Doctors use a set of criteria to allow an overhead athlete to return to competition. This study highlights that the techniques employed to evaluate these criteria are not always thoroughly validated by literature reviews.

LEVEL OF EVIDENCE: III; Observational study.