In elite sports, the shoulder is often pushed to its structural and functional limits. Subjected to high loads, repetitive stress, and complex movement patterns, the athletic shoulder must strike a balance between strength and mobility. From high-velocity throwing in baseball to overhead impacts in handball, it endures extreme biomechanical demands.
The athletic shoulder is not defined by a single pathology but rather a dynamic spectrum of injuries and adaptations that challenge clinicians, therapists, and researchers alike.
Over the past decade, significant progress has been made in the surgical treatment and rehabilitation of the shoulder in sports. Arthroscopy remains the gold standard for most intra-articular procedures, offering precision, minimal invasiveness, and faster recovery for athletes. Simultaneously, rehabilitation protocols emphasizing neuromuscular control, scapular kinematics, kinetic chain restoration, and psychological readiness have gained widespread appreciation.
Today, individualized care plans based on evidence and performance metrics are the standard. Biomechanical modeling, artificial intelligence in imaging interpretation, and biological augmentation for tissue healing are already influencing clinical practice. One could argue that interdisciplinary collaboration remains at the heart of effective care of the athlete’s shoulder.
With this in mind, I have invited my esteemed colleagues at Aspetar—shoulder surgeon Dr. Gazi Huri and physiotherapist Matthew Rees, who specializes in shoulder rehabilitation—to serve as guest editors for this targeted topic issue on Athletes' Shoulder. Together, they assembled a distinguished team of experts from Aspetar and around the world.
The surgical papers in this issue primarily focus on complex challenges in the elite shoulder, particularly anterior shoulder instability. A key question emerges: Can surgical stabilization restore competitive readiness, or does it merely create a stable but not elite shoulder?
Arthroscopic Bankart repair remains the most common surgical technique for athletes with minimal bone loss and high functional demand. However, growing evidence supports early consideration of bony augmentation procedures, such as the Latarjet, in cases of subcritical glenoid bone loss, especially among contact athletes.
Rehabilitation following instability repair is far from passive. Postoperative protocols must extend beyond capsular healing to address scapular mechanics, neuromuscular control, and physiological readiness.
Meanwhile, overhead athletes often display predictable dysfunction patterns, including internal impingement, labral pathology, and rotator cuff tendinopathy. However, each case is nuanced by sport-specific mechanics, age, and training history.
Thus, the role of the physiotherapist is critical not only in restoring mobility and strength but also in monitoring sport-specific movement patterns and assessing the athlete’s capacity to safely return to high-risk zones.
In addition to the excellent papers featured in this issue, I am pleased to introduce our latest section, “Al Resalah,” led by our newest team member, Qatari journalist Fai Al Naimi. This section highlights original and creative stories that reflect the country’s people, history, narratives, innovation, and excellence.
Within this issue, Fai had the opportunity to interview Adriana Vilagoš, a 20-year-old Serbian javelin world star, as part of our exclusive interview section. Additionally, Fai wrote a feature story with former football legend Mohammed Ghanim Al Rumaihi. By presenting these two remarkable figures—a rising star and a celebrated legend—we proudly present a unique blend of past and present in the world of sport. Reflecting this theme, for the first time, our cover page features photographs of both the former legend and the rising star.
I would also like to draw your attention to the "Psychological Return-To-Performance Pathway," written by Andrew Mitchell and co-authors, who share valuable insights into managing injured soccer players. Andrew Mitchell also shares memories from Leipzig, a historic German city. I especially encourage our younger colleagues to explore the legacy of the University of Leipzig, a long-standing leading institution in sports medicine and sports science. It remains a pivotal place for understanding the foundations of our field. As the saying goes, “In history, there is nothing new—only things we have forgotten.”
To enhance the journal’s aesthetic appeal, we proudly feature photography by Dr. Liesel Geertsema, a valued member of our editorial board. Her work, spanning four continents, offers readers a visual journey that feels like a message through a warm hole. Dr. Liesel Geertsema continues the proud tradition of physicians who, beyond their medical careers, have distinguished themselves as writers, painters, photographers, and artists.
Finally, I want to sincerely thank our guest editors, Dr. Gazi Huri and Matthew Rees, for their hard work and dedication. I am also grateful to all the authors for their valuable contributions.
I would like to conclude this target topic issue on the athletic shoulder with a shared message from all contributors: interdisciplinary collaboration remains at the core of effective care for the athlete’s shoulder.
I hope you enjoy reading this issue.
Prof Nebojsa Popovic MD PhD
Editor-in-Chief