Posterior Shoulder Soft Tissue Stabilization Return to Play Criteria Vary Among Investigations: A Systematic Review

Despite increasing rates of posterior shoulder instability surgery, return-to-play (RTP) rates vary widely. There is little available literature regarding specific criteria used to allow unrestricted RTP. We aimed to identify and describe the criteria used in the existing literature for the unrestricted RTP of individuals after posterior shoulder instability surgery. A systematic review was performed from inception through September 2024 including 1366 shoulders. The criteria used and their associated frequencies were identified as follows: Time (56%), Strength (48%), Range of Motion (41%), Sport-specific protocol (11%), Proprioception (4%), Other (15%). Many studies used a combination of the above listed criteria. We demonstrated there is little consensus regarding post-operative RTP criteria for posterior shoulder instability. Time, strength, and range of motion were the most used criteria, yet even within these categories there was variation in the length of time and degree of strength/range of motion used to guide RTP.