Pasqualini Ignacio, Hurley Eoghan T, Khan Shujaa T, Soares Rui W, Grobaty Lauren, Johnson Cole, Lau Brian C, Tjong Vehniah K, Rossi Luciano A
Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA.
Department of Orthopedic Surgery, Division of Hand and Upper Extremity, Duke University, Durham, NC, USA.
Open Access J Sports Med. 2025 Jun 7;16:55-65. doi: 10.2147/OAJSM.S505455. eCollection 2025.
Shoulder instability is a common injury in athletes that often requires surgical stabilization. While RTS rates after shoulder stabilization may be around 81%, approximately 19-52% of athletes do not return to their preinjury level of play. Psychological factors like fear of reinjury, lack of motivation, and change in priorities are key barriers to RTS after shoulder surgery. The Shoulder Instability Return to Sport after Injury (SIRSI) scale quantitatively assesses athletes' psychological readiness to return to sport following shoulder stabilization. Higher SIRSI scores correlate with increased likelihood of returning to preinjury level of play. However, current RTS guidelines rely heavily on time-based criteria and lack consensus on assessing psychological readiness. Adopting a more comprehensive approach that incorporates physical and psychological evaluations may better determine athletes' readiness to RTS. Incorporating the SIRSI scale into the RTS decision-making process, alongside physical evaluations, can potentially improve RTS outcomes in athletes after shoulder stabilization surgery. Further research is needed to establish standardized protocols and validate the effectiveness of interventions aimed at optimizing psychological readiness.
肩部不稳定是运动员常见的损伤，通常需要手术稳定治疗。虽然肩部稳定治疗后的重返运动（RTS）率可能约为81%，但仍有大约19 - 52%的运动员无法恢复到受伤前的运动水平。诸如害怕再次受伤、缺乏动力以及优先事项改变等心理因素是肩部手术后RTS的关键障碍。肩部损伤后重返运动（SIRSI）量表定量评估运动员在肩部稳定治疗后重返运动的心理准备情况。SIRSI得分越高，恢复到受伤前运动水平的可能性就越大。然而，当前的RTS指南严重依赖基于时间的标准，在评估心理准备方面缺乏共识。采用更全面的方法，将身体和心理评估结合起来，可能会更好地确定运动员的RTS准备情况。将SIRSI量表纳入RTS决策过程，同时进行身体评估，有可能改善肩部稳定手术后运动员的RTS结果。需要进一步的研究来建立标准化方案，并验证旨在优化心理准备的干预措施的有效性。
