A Hill-Sachs lesion is a dent or groove that forms on the upper arm bone (humeral head) when it pops out of the shoulder socket. Picture it like a small chip on a golf ball after hitting a hard surface. This happens when the shoulder dislocates, usually moving forward, causing the bone to scrape against the edge of the shoulder joint.

​

How Does It Happen?

​

Most Hill-Sachs lesions happen during shoulder dislocations, typically from falls or sports injuries. When the upper arm bone moves out of the front of the shoulder socket, it hits the edge of the socket, creating a dent. This can happen after just one dislocation or if the shoulder repeatedly becomes unstable. High-impact activities like contact sports or heavy lifting increase the risk of a Hill-Sachs lesion.

​

Common Signs and Symptoms

​

If you have a Hill-Sachs lesion, you may notice:

• Shoulder pain when lifting your arm or reaching overhead.

• A feeling that your shoulder is unstable or could pop out again.

• Restricted movement or difficulty moving your shoulder fully.

• Weakness in the shoulder or arm when trying to use it.

The severity of symptoms depends on the size of the dent and whether other shoulder injuries are involved.

​

How to Treat Weightlifter’s Shoulder

​

Treatment varies based on the size of the lesion. For minor cases, rest, specific exercises, and possibly wearing a brace can help strengthen the shoulder and improve stability. If the lesion is larger or the shoulder frequently dislocates, surgery might be needed.

• The Remplissage procedure smooths out the dent to prevent the bone from catching on the shoulder socket.

• The Latarjet procedure adds a small piece of bone to the shoulder socket, making it more stable.

​

The Role of Physiotherapy in Recovery

​

Physiotherapy plays a critical role in recovery, whether you’ve had surgery or not. A physio can guide you through exercises that strengthen the shoulder muscles, improve stability, and restore movement. Starting with gentle stretches, the program gradually increases in intensity as your shoulder heals. Research shows that following a rehab program lowers the risk of future dislocations and leads to better long-term results.

​

​​​​​

​

​

References

• Camus, P., et al. (2021). Management of off-track Hill-Sachs lesions in anterior glenohumeral instability. Journal of Experimental Orthopaedics.

• Di Giacomo, G., et al. (2021). Treatment strategies for Hill-Sachs lesions: A comprehensive review. Journal of Shoulder and Elbow Surgery.

• García, J. C., et al. (2021). Surgical outcomes and recurrence rates for Hill-Sachs lesions. Orthopaedic Reviews.

• Griesser, M. J., et al. (2022). Risk factors and outcomes for Hill-Sachs lesion treatments. Knee Surgery, Sports Traumatology, Arthroscopy.

• Hurley, E. T., et al. (2023). Long-term outcomes following surgical management of Hill-Sachs lesions. Journal of Sports Medicine.