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Evidence Practice Guidelines: 2022 Bern Consensus Statement on Shoulder Injury Prevention, Rehabilitation and Return to Sport for Athletes at All Participation Levels

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Synopsis

There is an absence of high-quality evidence to support rehabilitation and return-to-sport decisions following shoulder injuries in athletes. The Athlete Shoulder Consensus Group was convened to lead a consensus process that aimed to produce best-practice guidance for clinicians, athletes, and coaches for managing shoulder injuries in sport. We developed the consensus via a 2-round Delphi process (involving more than 40 content and methods experts) and an in-person meeting. This consensus statement provides guidance with respect to load and risk management, supporting athlete shoulder rehabilitation, and decision making during the return-to-sport process. This statement is designed to offer clinicians the flexibility to apply principle-based approaches to managing the return-to-sport process within a variety of sporting backgrounds. The principles and consensus of experts working across multiple sports may provide a template for developing additional sport-specific guidance in the future. J Orthop Sports Phys Ther 2022;52(1):11–28. doi:10.2519/jospt.2022.10952

 

Summary

When supporting athletes to manage shoulder injury (including avoiding primary injury, designing appropriate rehabilitation, and supporting shared RTS decisions), we encourage clinicians to start by identifying the individual demands of the sport. Such an approach will form a solid base from which to effectively apply the principles we describe in this consensus statement in practice.

This statement sets out expert consensus-level guidance on how to frame the key decisions when supporting athletes to return to their sport. Load and risk management underpin primary and secondary prevention efforts, as well as the RTS continuum after an injury. We provide 7 key principles to consider when guiding an athlete through shoulder rehabilitation. We finish by outlining the 6 domains to consider as part of the RTS decision-making process: pain; active shoulder joint ROM; strength, power, and endurance; the kinetic chain; psychology; and return to sport-specific activities………….