Research question: Mountain bikers and shoulder dislocation

This research idea refuses to leave my head:

Shoulder dislocations frequently happen as a result of a FOOSH, or a fall on a hyperflexed arm... and both of these falls may occur while mountain biking. And women (my professors say, especially blond or redheaded women, but I don't have enough clinical experience to personally know that yet) more frequently have shoulder instability. It's also true that, once you dislocate your shoulder, you have an 80% chance of re-dislocating it, and surgery is required to repair it.

Hmm, I wonder how these things are related, and I wonder how I can keep the mountain bikers on my racing team out of the OR and on the trails. (This idea was inspired by a woman who's earned the nickname "Bella Loca", because she falls on her MTB, dislocates her shoulder, pops it back in, gets back on, and keeps racing.... and by another woman who dislocated her shoulder while racing, and now it occasionally dislocates when she sleeps.)

Things I would want to study and/or prove:

Thesis 1) Female mountain bikers are more prone to dislocation than the general population of women, and risk of dislocation rises with some criteria (riding frequency or racing category or amount of instability or score on a proprioception test?)

Thesis 2) Pre-emptively screening female mountain bikers for shoulder instability and poor proprioception, and teaching them a home exercise program that improves both of those, decreases their risk of traumatic dislocation.

Home exercise programs: How do you get people to do them?

One of our assigned articles in school was an article on home exercise programs and whether people do them or not. The study was conducted at a nursing home, and it found that people were more likely to do the exercises that you give them if you:

- Keep it to three or fewer exercises.
- Explain the exercises carefully and give them a chance to practice while you supervise.


In thinking about it, the exercise programs I've seen work most successfully are ones that already fit with the patient's current life. Example:

- To stretch your calf muscles, put a 2' section of 4x4 under your desk, and rest your toes on it.

- To give yourself periodic breaks from typing, get a 12 oz mug. Fill it with water when you get to work. Take periodic sips throughout the day, such that you need to get up and refill it every 1-2 hours.

- Every time you see the color red, do a posterior pelvic tilt.

- When you're watching TV, do quad sets during the commercials.

- Do the brief exercises I give you before and after you work out.

What doesn't work? Exercise programs that require people to stop what they are doing, get the specialized equipment that you provide them, and do the exercises.

Hmm.