Management of the overhead athlete presenting with anterior instability requires an identification of factors influencing successful therapeutic intervention strategies. The importance of differentiating a diagnosis, of knowing something of the demands of the sport, and of addressing pertinent anatomical and biomechanical considerations of the throwing shoulder prior to implementing rehabilitation programs must be considered. An appreciation of the complexities of the throwing shoulder serves as a basis for the selection of rehabilitation activities aimed at returning the athlete to pretrauma levels of overarm proficiency. The challenge of regaining normal shoulder joint osteokinematics and neuromuscular function at a competitive status is described in terms of the proper selection and sequencing of rehabilitation exercises for the initiation and progression of range of motion, muscle strength, muscle reducation, and sport-specific functional activities. Time frames for progressing the various stages of rehabilitation, indications for exercise selection based on electromyographic studies, and attention to detail with regard to exercise execution are emphasized.
CM. Bonci is with Intercollegiate Athletics for Women at The University of Texas at Austin, Austin, TX 78712. B. Sloane is with Orthopaedic Rehabilitation Affiliates, Cedardale Athletic Club, Haverhill, MA 01830. K. Middleton is with the Athletic Training Staff at Stanford University, Stanford, CA 94305.