Shoulder instability in young athletes: when to operate, when to wait
A first-time dislocation in a 16-year-old is a different problem than the same injury in a 35-year-old. The data is clearer than most patients realize.
Samuel Howard, D.O.
Orthopedic surgery, sports medicine
Roughly nine out of ten young athletes who dislocate a shoulder will do it again. That statistic, more than anything else, shapes how we think about surgical timing.
The Bankart lesion — a tear of the labrum at the front of the shoulder — is what makes the joint structurally unstable after a first dislocation. Conservative management can be appropriate, but in patients under 25 who play contact or overhead sports, the recurrence rate without surgery is high enough that early stabilization is often the more durable choice.
Surgical decision-making depends on the patient's sport, age, the appearance of the labrum on MRI, and whether there's any bone loss on the glenoid. We talk through every one of those factors before recommending an operation.
The work that matters happens in the months before and after the operation — not just on the table.
If you have a question about anything in this post, the office line is the fastest way to reach the team. We're happy to talk through it.
