Predictors of return to work after shoulder injuries: The influence of health perception and job characteristics

Shoulder injuries are prevalent among working populations and may significantly delay return to work (RTW). Identifying predictors of successful RTW is crucial for designing effective interventions. This study aimed to assess the RTW status and its determinants among patients with shoulder injuries. In this retrospective cohort study with prospective follow-up, 340 patients with shoulder injuries— such as acromioclavicular joint dislocation, clavicle fractures, and shoulder instability—treated between 2016 and 2020 were included. Data were obtained from medical records and structured telephone interviews. Demographic and clinical variables, health-related quality of life (SF-12), and perceived support from employer and colleagues were assessed. Multivariate logistic regression was used to identify predictors of RTW. Among 340 participants, 67.9% returned to their previous job, 14.1% returned with modifications, 14.4% obtained new employment, and 3.5% did not return to work. Multivariate analysis showed that coworker support (OR=1.88, p < 0.001) was positively associated with RTW, whereas lower employer support (OR=0.585, p < 0.001), lower SF‑12 scores (OR=0.895, p = 0.023), and white‑collar occupation (OR=0.015, p < 0.001) were associated with reduced likelihood of RTW. In addition, health insurance coverage and certain injury types were significantly related to RTW outcomes. RTW after shoulder injuries is mainly influenced by multiple occupational, clinical, and psychosocial factors. Workplace support, overall health status, and job characteristics play important roles in facilitating occupational reintegration. Strengthening rehabilitation programs and workplace support systems may improve RTW outcomes among injured workers.