Injuries to the shoulder can be broadly categorized as traumatic or degenerative. Changes in lifestyle have made individuals more active at both advanced and early ages, leading to an increase in the incidence of shoulder injuries across different age groups.

While shoulder injuries are commonly associated with individuals over 65 years old, we are witnessing a growing number of adolescents engaging in intense sports activities, making them susceptible to injuries. Nowadays, these young patients benefit from minimally invasive surgeries to address their issues and return to competition as quickly as possible.

To illustrate this, we present a case of a 14-year-old female athlete with chronic shoulder pain. She is actively involved in handball, undergoing rigorous training and participating in intense matches as a goalkeeper. Shoulder pain during activities above shoulder height significantly limits her performance in this sport. Despite undergoing prior rehabilitation, the pain persists. Although she has full range of motion and denies previous episodes of glenohumeral shoulder dislocation, her examination reveals anterior drawer sign, indicating anterior shoulder instability.

Anatomically, there is a size disproportion between the articular part of the humerus and the glenoid of the scapula. To address this situation and provide stability to this highly mobile joint, a kind of suction cup is used to equalize the size of the glenoid and better secure the humerus. Damage to this structure leads to instability problems. When the injury is small, it falls under the category of microinstability, progressing to frank instability as the injury advances, causing the shoulder to dislocate in certain positions according to the pattern of the injury. This type of injury is generally known as SLAP (Superior Labrum Anterior and Posterior tear), referring to its position relative to the insertion of the long head of the biceps.

Traditionally, surgery was reserved for advanced stages with multiple dislocations. However, current trends recommend early repair to prevent progression to more severe injuries and achieve more satisfactory results. The patient underwent arthroscopic intervention, involving the delimitation of the lesion, release of the scarred labrum, creation of a bony edge for reattachment, and suturing it to the bone using available implant models. The amount of capsular tissue applied depends on the type of injury, adding greater stability if necessary.

Due to instability, it is not uncommon to find some component of injury in the associated subacromial space. Arthroscopy allows for a precise diagnosis of potential injuries, enabling minimally invasive intervention for all identified issues. In this patient’s case, in addition to the SLAP lesion, subacromial syndrome was treated—a condition involving the inflammation of a bursa cushioning the passage of rotator cuff tendons beneath the acromioclavicular joint, often secondary to the shape of the acromion’s free edge irritating the tendons.

Both the intervention and subsequent rehabilitation are crucial in treating these types of injuries. Initially, a sling is used, which is gradually removed in the first few weeks for home exercises. Subsequently, a physiotherapy regimen is established. Specifically, this patient achieved a full range of motion at 8 weeks, and at 12 weeks, she was allowed to gradually resume sports activities. In the videos, it is evident that she can fully elevate the operated shoulder without distinction from the non-operated shoulder to make significant saves.