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Abstract

There has been an increasing focus on sex-specific differences within the context of sports medicine. Differences exist between the sexes leading to disparities in the types of injuries female athletes sustain and the rates at which they experience them. Recognition and awareness of subtle differences between the sexes can lead to a more nuanced diagnosis and treatment of such injuries. The purpose of this study is to review shoulder pathologies that are relevant to the female athlete, specifically adhesive capsulitis, multidirectional instability, and traumatic unidirectional shoulder instability, and highlight the differences in diagnosis, treatment, and outcomes between the sexes. Women suffer from adhesive capsulitis at a greater rate than men and there are risk factors such as breast cancer surgery that are unique to women. Females are much more likely to experience atraumatic shoulder instability than their male counterparts. While females represent a minority of patients who suffer traumatic unidirectional shoulder instability, they should not be overlooked with regards to this condition. There are challenges related to the diagnosis and treatment of these pathologies that are distinctive to female athletes. Adhesive Capsulitis Genetics and Sex-Specific Risk FactorsAdhesive capsulitis is a morbid condition that can lead to substantial functional loss and impairment in activities of daily living. It occurs in 2-5% of the population but disproportionately affects women with a male to female ratio reported between 1:1.5 and 1:1.8 [3][4][5] . Other risk factors include diabetes mellitus, autoimmune diseases, cerebral vascular accidents, myocardial infarctions, and recent surgery 6 . Furthermore, females with adhesive capsulitis tend to have a higher intensity of shoulder pain than males 7 .