Posterior labral injury in contact athletes

Nine athletes (seven football offensive linemen, one defensive lineman, and one lacrosse player) were found at arthroscopy to have posterior labral de tachment from the glenoid. In our series, this lesion is specific to contac t athletes who engage their opponents with arms in front of the body, All p atients had pain with bench pressing and while participating in their sport , diminishing their ability to play effectively. Conservative measures were ineffective in relieving their symptoms. Examination under anesthesia reve aled symmetric glenohumeral translation bilaterally, without evidence of po sterior instability. Treatment consisted of glenoid rim abradement and post erior labral repair with a bioabsorbable tack. All patients returned to com plete at least one full season of contact sports and weightlifting without pain (minimum follow-up, greater than or equal to 2 years). Although many i njuries leading to subluxation of the glenohumeral joint occur when an unan ticipated force is applied, contact athletes ready their shoulder muscles i n anticipation of impact with opponents. This reads to a compressive force at the glenohumeral joint. We hypothesize that, in combination with a poste riorly directed force at impact, the resultant vector is a shearing force t o the posterior labrum and articular surface. Repeated exposure leads to po sterior labral detachment without capsular injury. Posterior labral reattac hment provides consistently good results, allowing the athlete to return to competition.