Protective Sport Bracing for Athletes With Mid-Season Shoulder Instability.

Sports Health · 2023 · Review

Baker HP, Krishnan P, Meghani O, Athiviraham A, Ho S, Owens BD

Department of Orthopaedic Surgery, The University of Chicago, Chicago, Illinois

SUMMARY — THE REDUCTIONThis review of functional bracing for in-season shoulder instability in athletes finds mixed, low-quality evidence with possible return-to-play benefit and minimal downside, making bracing a reasonable individual choice, especially in high-risk sports like football.

Abstract, as published

CONTEXT: In-season glenohumeral instability is a common clinical dilemma faced by physicians who care for athletes. Both nonoperative and operative management of athletes with in-season glenohumeral instability have been well described. Functional bracing remains less understood as a treatment modality. This review aims to provide an update on the most recent literature regarding the use of functional bracing for shoulder instability.

EVIDENCE ACQUISITION: MEDLINE (PubMed and Ovid platforms), Web of Science, Embase, and Cochrane Database of Systemic Reviews were searched for articles available in English through June 1, 2021. The search terms shoulder brace, shoulder instability, athlete, in-season, glenohumeral instability, anterior shoulder instability, posterior shoulder instability, and bracing were used.

RESULTS: Research on the clinical outcomes of functional bracing remains mixed for patients with shoulder instability. Two studies have demonstrated improved return to play with functional bracing, while 1 study demonstrated no difference in return to play between braced athletes and nonbraced athletes with anterior instability. One previous study demonstrated that prophylactic use of bilateral shoulder stabilizing braces significantly decreased time lost due to injury in athletes with posterior instability. Previous biomechanical studies have demonstrated improved proprioception with brace wear as well as successful limitation of active shoulder range of motion.

CONCLUSION: Bracing in athletes with shoulder instability remains an important nonoperative treatment modality. While clinical benefits are yet to be validated through high-quality studies, preliminary results suggest a potential benefit to recovery, with minimal downsides. Nevertheless, the use of bracing remains an individual choice but is especially recommended in settings of high-risk sports for shoulder instability, such as football.

STUDY DESIGN: Clinical review.

LEVEL OF EVIDENCE: Level 3.

Read the article: PubMed · Publisher (DOI)

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