The research, “Sex-specific Considerations for Shoulder Instability and Adhesive Capsulitis in Females,” was published online on May 19, 2022 in the Journal of Orthopedics and Orthopedic Surgery.
Females More Likely to Develop Adhesive Capsulitis
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“There has been an increased focus on sex-specific differences in sports medicine, specifically with regards to prevention, presentation, and management of athletic injuries. Anatomic, biomechanical, hormonal, and psychologic differences exist between the sexes leading to disparities in the types of injuries female athletes sustain and the rates at which they experience them,” the researchers wrote.
“Women are more susceptible to overuse injuries and among directly comparable sports, they are more likely than men to sustain injuries requiring surgical management. These differences have been described in the hip, knee, and ankle, and the shoulder is no exception.”
In their study, the researchers reviewed shoulder pathologies that are relevant to the female athlete: adhesive capsulitis, multidirectional instability, and traumatic unidirectional shoulder instability. They wanted to highlight the differences in diagnosis, treatment, and outcomes between the sexes.
Their data showed that women develop adhesive capsulitis at a faster rate than men and that there are risk factors unique to women. Female athletes are also more likely to experience traumatic shoulder instability than male athletes.
The researchers also noted that while only a small minority of female athletes experience traumatic unidirectional shoulder instability, they shouldn’t be overlooked in the study of this condition.
“There are challenges related to the diagnosis and treatment of these pathologies that are distinctive to female athletes. Recognition and awareness of subtle differences between the sexes can lead to a more nuanced diagnosis and treatment of such injuries,” the researchers wrote.
Study authors include Kathryn A. Barth, Claire D. Ellasberg, and Karen M. Sutton of Hospital for Special Surgery, New York, New York.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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