A qualitative investigation to identify return to sports criteria after shoulder stabilization surgery used by professional team physicians

Purpose: Purpose of this study is to explore currently utilized readiness to return to sports (RTS) criteria after shoulder stabilization surgery used in elite athletes to gain novel insights into the RTS decision making process of professional team physicians.Methods: 19 qualitative semi-structured interviews with professional team physicians were conducted by a single trained interviewer. The interviews were used to identify team physician concepts and themes regarding the criteria used to determine RTS after shoulder stabilization surgery. General inductive analysis and a coding process were used to identify themes and sub-themes arising from the data. A hierarchical approach in coding helped to link themes.Results: We were able to identify five key themes that participating physicians focused on to determine RTS decision making: external influence, objective and subjective criteria, time elapsed since surgery and type of sport. The most important RTS criteria included: range of motion and muscle strength followed by clinical joint stability, time since surgery, ability of sporting movement, psychological readiness, functional testing, absence of pain and allied team support.Conclusion: This study identified several main themes and subordinate minor themes as having the most influence on RTS decision after shoulder surgery. We showed that even among specialized professional team physicians, the main criteria to RTS in these categories were inconsistent necessitating the future development of specific RTS guidelines.