Shoulder surgery recovery hinges on joint awareness

NEW YORK (Reuters Health) - Following a sports-related shoulder injury, the likelihood that a person will be able to throw or hit a ball as well as they once did depends on their ability to sense the position of their injured arm at the shoulder joint, German researchers report.

The results highlight the fact that while most shoulder surgeries are deemed a success, only about half of the patients are able to return to their previous level of sports activity.

Overhead activities, such throwing, tennis and volleyball, are associated with injuries leading to shoulder instability. Dr. Reinhard W. Fremerey, from Klinikum Hildesheim, and colleagues advise that patients be cautioned that corrective surgery will help, but they may not be restored to previous sports performance levels.

In their study, 22 athletes with shoulder injuries underwent a standard reconstructive procedure. After an average follow-up of 2.8 years, the investigators compared the group with 20 athletes who had no history of shoulder pain or injury.

Nineteen patients were free of pain, while three reported exercise-dependent pain. In general, subjects were very satisfied with the surgery result as indicated by an average score of 8.1 on a 10-point satisfaction scale (10 = most satisfied).

Despite these good outcomes, only 12 patients returned to their prior levels of sport activities, the investigators report in the International Journal of Sports Medicine.

Subjects in the comparison group were able to accurately tell the position of the arm in relation to the shoulder without looking, a feat that many patients in the surgery group were unable to do. Of the 12 patients who regained their pre-injury levels of activity, 9 were able to correctly identify joint position at the shoulder.

In light of these findings, the researchers recommend shoulder rehabilitation programs be developed to restore joint position awareness along with power and movement.

SOURCE: International Journal of Sports Medicine, August 2006.