Shoulder Instability-Return to Sport after Injury (SI-RSI)

Objective

The SI-RSI score is a tool used to quantify athletes’ psychological readiness to return to sport following traumatic shoulder instability.¹ ²

Interpretation

High scores indicate a positive psychological response.¹ ²

A cut-off score of 55 or higher indicates that an athlete is psychologically ready to return to sport, and also predicts a return to the pre-injury level of sports participation.⁴

For every 10-point increase in the SI-RSI score, the odds of returning to sport are reported to increase 2.9-fold.³

Execution

Based on the ACL-RSI scale, the term “knee” has been replaced with “shoulder.” The SI-RSI score consists of 12 questions using an 11-point Likert scale ranging from 0 to 10. The total score is calculated by adding the values of the 12 responses and then applying a formula (× 100/120) to obtain a percentage.¹ ²

Duration

A few minutes.

Equipment

None.

Clinical Value

The SI-RSI score is a valid and reproducible scale that identifies patients who are psychologically ready to return to their sport after an episode of shoulder instability.¹ ³

In the original validation study, internal consistency was high (α = 0.96) and test-retest reproducibility was excellent (ρ = 0.93, 95% CI [0.89–0.96], p < 10⁻⁵), with no ceiling or floor effects.¹

Acknowledgements

The SI-RSI was developed in the original publication: Gerometta A., Klouche S., Herman S., Lefevre N., Bohu Y. Knee Surgery, Sports Traumatology, Arthroscopy. 2018;26(1):203–211.

We would like to thank Dr. Alexandre Hardy for granting us permission, on behalf of the authors, to make the SI-RSI available on Fullphysio.

1- Gerometta, A., Klouche, S., Herman, S., Lefevre, N., & Bohu, Y. (2018). The Shoulder Instability-Return to Sport after Injury (SIRSI): a valid and reproducible scale to quantify psychological readiness to return to sport after traumatic shoulder instability. Knee Surgery, Sports Traumatology, Arthroscopy, 26(1), 203–211.

2- Louati, A., Bouche, P. A., Bauer, T., & Hardy, A. (2022). Translation and validation of the shoulder instability-return to sport after injury (SIRSI) score in French. Journal of Experimental Orthopaedics, 9(1), 41.

3- Rossi, L. A., Pasqualini, I., Brandariz, R., Fuentes, N., Fieiras, C., Tanoira, I., & Ranalletta, M. (2022). Relationship of the SIRSI Score to Return to Sports After Surgical Stabilization of Glenohumeral Instability. The American Journal of Sports Medicine, 50(12), 3318–3325.

4- Pasqualini, I., Hurley, E. T., Khan, S. T., Soares, R. W., Grobaty, L., Johnson, C., Lau, B. C., Tjong, V. K., & Rossi, L. A. (2025). Psychological Readiness for Return to Sport After Shoulder Stabilization Surgery: A Review of Current Evidence and the Role of The Shoulder Instability Return to Sport After Injury (SIRSI) Scale. Open Access Journal of Sports Medicine, 16, 55–65.