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Return to Play After Rotator Cuff Surgery

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Return to Play in Football

Abstract

Numerous shoulder injuries occur after a high-energy trauma or repeated microtrauma in football players. Many lesions are described, and type of trauma, patient’s symptoms, player’s role, and optimal timing for surgical treatment must be thoroughly evaluated.

Treatment of rotator cuff tears in athletes is challenging, considering the high level of activities and the need of a fast recovery and return to sports activities. In many patients a conservative treatment is initially proposed, consisting of shoulder immobilization with a sling for a brief period followed by a rehabilitation period. Surgery is indicated for athletes with severe pain and/or functional limitation and, if possible, is performed at the end of the season. Only 49.9% of professional athletes return to play at the same level after rotator cuff repair, and in partial lesions involving <50% of the thickness of the tendon, an arthroscopic debridement, followed by an accelerated rehabilitation protocol, is often recommended. After rotator cuff injuries, football players may return to their athletic activity in 5–7 months. A good decision-based return to play relies on a three-step model assessment: evaluation of health status, participation risk, and specific aspects of the single case (decision modification).

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Top Five Evidence Based References

  • Creighton DW, Shrier I, Shultz R, Meeuwisse WH, Matheson GO (2010) Return-to-play in sport: a decision-based model. Clin J Sport Med 20(5):379–385

    Article  PubMed  Google Scholar 

  • Ejnisman B, Barbosa G, Andreoli CV, de Castro Pochini A, Lobo T, Zogaib R, Cohen M, Bizzini M, Dvorak J (2016) Shoulder injuries in soccer goalkeepers: review and development of a FIFA 11+ shoulder injury prevention program. Open Access J Sports Med 7:75–80

    Article  PubMed  PubMed Central  Google Scholar 

  • Hart D, Funk L (2015) Serious shoulder injuries in professional soccer: return to participation after surgery. Knee Surg Sports Traumatol Arthrosc 23(7):2123–2129

    Article  PubMed  Google Scholar 

  • Klouche S, Lefevre N, Herman S, Gerometta A, Bohu Y (2016) Return to sport after rotator cuff tear repair: a systematic review and meta-analysis. Am J Sports Med 44(7):1877–1887

    Article  PubMed  Google Scholar 

  • Randelli P, Arrigoni P, Ragone V, Aliprandi A, Cabitza P (2011) Platelet rich plasma in arthroscopic rotator cuff repair: a prospective RCT study, 2-year follow-up. J Shoulder Elbow Surg 20(4):518–528

    Article  PubMed  Google Scholar 

References

  1. Arai R, Sugaya H, Mochizuki T et al (2008) Subscapularis tendon tear: an anatomic and clinical investigation. Arthroscopy 24:997–1004

    Article  PubMed  Google Scholar 

  2. Tuite MJ (2012) Magnetic resonance imaging of rotator cuff disease and external impingement. Magn Reson Imaging Clin N Am 20:187–200. ix

    Article  PubMed  Google Scholar 

  3. Braun S, Kokmeyer D, Millett PJ (2009) Shoulder injuries in the throwing athlete. J Bone Joint Surg Am 91:966–978

    Article  PubMed  Google Scholar 

  4. Dillman CJ, Fleisig GS, Andrews JR (1993) Biomechanics of pitching with emphasis upon shoulder kinematics. J Orthop Sports Phys Ther 18:402–408

    Article  CAS  PubMed  Google Scholar 

  5. Ejnisman B, Barbosa G, Andreoli CV et al (2016) Shoulder injuries in soccer goalkeepers: review and development of a FIFA 11+ shoulder injury prevention program. Open Access J Sports Med 7:75–80

    Article  PubMed  PubMed Central  Google Scholar 

  6. Hart D, Funk L (2015) Serious shoulder injuries in professional soccer: return to participation after surgery. Knee Surg Sports Traumatol Arthrosc 23:2123–2129

    Article  PubMed  Google Scholar 

  7. Bigliani L, April E (1986) The morphology of the acromion and rotator cuff impingement. Orthopedic Transcription

    Google Scholar 

  8. Meister K, Andrews JR (1993) Classification and treatment of rotator cuff injuries in the overhand athlete. J Orthop Sports Phys Ther 18:413–421

    Article  CAS  PubMed  Google Scholar 

  9. Paulson MM, Watnik NF, Dines DM (2001) Coracoid impingement syndrome, rotator interval reconstruction, and biceps tenodesis in the overhead athlete. Orthop Clin North Am 32(485-493):ix

    Google Scholar 

  10. Walch G, Boileau P, Noel E et al (1992) Impingement of the deep surface of the supraspinatus tendon on the posterosuperior glenoid rim: an arthroscopic study. J Shoulder Elbow Surg 1:238–245

    Article  CAS  PubMed  Google Scholar 

  11. Snyder SJ (1994) Diagnostic arthroscopy: normal anatomy and variations. In: Shoulder arthroscopy. McGraw-Hill, Inc., New York, NY

    Google Scholar 

  12. Andrews JR, Broussard TS, Carson WG (1985) Arthroscopy of the shoulder in the management of partial tears of the rotator cuff: a preliminary report. Arthroscopy 1:117–122

    Article  CAS  PubMed  Google Scholar 

  13. Blevins FT (1997) Rotator cuff pathology in athletes. Sports Med (Auckland, NZ) 24:205–220

    Article  CAS  Google Scholar 

  14. Jobe CM (1995) Posterior superior glenoid impingement: expanded spectrum. Arthroscopy 11:530–536

    Article  CAS  PubMed  Google Scholar 

  15. Jobe CM (1997) Superior glenoid impingement. Orthop Clin North Am 28:137–143

    Article  CAS  PubMed  Google Scholar 

  16. Nakagawa S, Yoneda M, Hayashida K et al (2001) Greater tuberosity notch: an important indicator of articular-side partial rotator cuff tears in the shoulders of throwing athletes. Am J Sports Med 29:762–770

    Article  CAS  PubMed  Google Scholar 

  17. Klouche S, Lefevre N, Herman S et al (2016) Return to sport after rotator cuff tear repair: a systematic review and meta-analysis. Am J Sports Med 44:1877–1887

    Article  PubMed  Google Scholar 

  18. Corpus KT, Camp CL, Dines DM et al (2016) Evaluation and treatment of internal impingement of the shoulder in overhead athletes. World J Orthoped 7:776–784

    Article  Google Scholar 

  19. Randelli P, Arrigoni P, Ragone V et al (2011) Platelet rich plasma in arthroscopic rotator cuff repair: a prospective RCT study, 2-year follow-up. J Shoulder Elbow Surg 20:518–528

    Article  PubMed  Google Scholar 

  20. Cuff DJ, Pupello DR (2012) Prospective evaluation of postoperative compliance and outcomes after rotator cuff repair in patients with and without workers’ compensation claims. J Shoulder Elbow Surg 21:1728–1733

    Article  PubMed  Google Scholar 

  21. Kim YS, Chung SW, Kim JY et al (2012) Is early passive motion exercise necessary after arthroscopic rotator cuff repair? Am J Sports Med 40:815–821

    Article  PubMed  Google Scholar 

  22. Klintberg IH, Gunnarsson AC, Svantesson U et al (2009) Early loading in physiotherapy treatment after full-thickness rotator cuff repair: a prospective randomized pilot-study with a two-year follow-up. Clin Rehabil 23:622–638

    Article  PubMed  Google Scholar 

  23. Koh KH, Lim TK, Shon MS et al (2014) Effect of immobilization without passive exercise after rotator cuff repair: randomized clinical trial comparing four and eight weeks of immobilization. J Bone Joint Surg Am 96:e44

    Article  PubMed  Google Scholar 

  24. Creighton DW, Shrier I, Shultz R et al (2010) Return-to-play in sport: a decision-based model. Clin J Sport Med 20:379–385

    Article  PubMed  Google Scholar 

  25. Shrier I, Safai P, Charland L (2014) Return to play following injury: whose decision should it be? Br J Sports Med 48:394–401

    Article  PubMed  Google Scholar 

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Correspondence to Alessandra Menon .

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Pulici, L., Zanini, B., Carrai, L., Menon, A., Compagnoni, R., Randelli, P. (2018). Return to Play After Rotator Cuff Surgery. In: Musahl, V., Karlsson, J., Krutsch, W., Mandelbaum, B., Espregueira-Mendes, J., d'Hooghe, P. (eds) Return to Play in Football. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-55713-6_25

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  • DOI: https://doi.org/10.1007/978-3-662-55713-6_25

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-55712-9

  • Online ISBN: 978-3-662-55713-6

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