Athletes participating in contact sports often subject their shoulders to intense activity and high-energy forces. When one or more of the posterior stabilizing structures is damaged, posterior shoulder instability often ensues. Orthopedists must know how to perform the specific physical examination maneuvers to determine posterior shoulder instability and what imaging tests are necessary. Initial management traditionally includes 6months of conservative nonoperative rehabilitation. If the athlete's shoulder instability persists after conservative treatment, surgery is directed at repairing any soft or bony lesions. Depending on the surgery performed, athletes may expect to gradually return to play between 5 and 8months.