Return to Play After Shoulder Instability in National Football League Athletes

OBJECTIVES: To determine the rate and timing of return to NFL play after a shoulder instability event and to determine what factors predict ability to Return to Play (RTP). METHODS: A total of 83 NFL players who sustained an in-season shoulder instability event while playing in the NFL were identified and evaluated. Return to NFL play, incidence of surgery, time to return, recurrent instability events, seasons and games played after injury, and demographic data were collected. Overall RTP was determined and players who had surgery were compared to those who did not have surgery. Playing time after RTP was compared with age, position, size and experience matched control players. RESULTS: Ninety-one percent of NFL players returned to NFL regular season play at an average of 1.6 ± 1.9 weeks (mean ± SD) in those sustaining a shoulder subluxation and 3.7 ± 5.4 weeks in those sustaining a dislocation; p = .53. In players who were able to RTP without surgery, those having a left shoulder instability event were able to return faster (1 week) than those having a right shoulder event (4 weeks); p = .03. A majority of players (62%) underwent surgical stabilization and 86% returned to play the following season. Players who had surgery were more likely to have a second instability event in their career (58% versus 9%); p = .01. No difference was found when comparing playing time after return with matched controls. CONCLUSION: There is a high rate of RTP following shoulder instability events in NFL players. Players sustaining subluxations in their non-dominant arm return to play at a faster rate. Surgical stabilization of the shoulder following an instability event may not ly eliminate potential for subsequent recurrent events as a high percentage of surgically treated players were found to have another instability event.