Classification and treatment of shoulder dysfunction in the overhead athlete.

There are two distinct pathological categories of shoulder injury. In the older population, shoulder injury is generally a result of the degenerative aging process. In the younger population, it is commonly a result of the repetitiousness of an overhead sport. In the latter group, instability is typically the core problem, leading to the continuum of subluxation, impingement, and rotator cuff tear. A classification scheme, proposing four definitive types of shoulder injury, assists in directing an effective management program. Once diagnosed (the first step of treatment) a conservative rehabilitation program that emphasizes strengthening of the glenohumeral protectors, scapulohumeral pivotors, humeral positioners, and power drivers is advised. The surgery of choice, for the small minority who fail to respond to the rehabilitation program, is the anterior capsulolabral reconstruction. A sports medicine team working together with the athlete is instrumental in his/her return to sport.