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Throwing athletes are subject to excessive external rotation and increased glenohumeral translation. In the throwing athlete with shoulder pain, it is essential to recognize that glenohumeral joint instability is often the primary underlying condition. Once the diagnosis is made, using tests such as the modified relocation maneuver, conservative management is usually effective. For athletes with continued symptoms, surgical intervention may become necessary. The anterior capsulolabral reconstruction addresses the problem of glenohumeral joint instability by correction of the capsular redundancy, labral damage, or both. The surgical technique and rehabilitation as described here, has resulted in a significant improvement in our ability to more predictably and successfully return overhead athletes to prior competitive levels.