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Successfully Playing Again After In-Season Shoulder Instability

Shoulder instability is a common occurrence with collision-based sports such as tackle football and rugby. Extensive available data suggests that repeat instability events for high school age athletes is exceptionally common, and for that reason orthopedic surgeons have become more likely to recommend surgery for first time shoulder instability.

However, recently published data shows that shoulder instability events can often be managed non-surgically with high rates of successful return in the same season. Furthermore one study indicates a very high rate of continued sport participation in the following season. This study shows that first time shoulder instability for athletes participating in collision-based sports can be managed without surgery in a much higher percentage of patients than we have previously believed.

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“Fortnite Shoulder”?

We are now about two weeks away from the start of the 2019 Little League World Series. There will be a lot of baseball, of course, but there’ll also be a lot of Fortnite and other video games being played. With that in mind I thought it would be interesting to take a look at an article published in 2018 showing a strong association between videogame playing and risk of shoulder and elbow injuries in baseball players.

Researchers from the Tohoku University School of Medicine in Japan found that players who spent three or more hours daily on videogames were 5.6 times more likely to have felt elbow or shoulder pain in the prior year than those who played videogames for less than an hour a day.

Could this possibly be real? Do we actually need to add extensive videogame playing to the list of risk factors for shoulder and elbow injuries amongst young baseball players?

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When Can I Play Again: Shoulder Separation

I’ve written recently about shoulder dislocation, a serious condition in which the ball portion of the shoulder (humerus) becomes completely dislodged from the socket. This week we’ll discuss a shoulder separation, another common shoulder injury. But first let’s clear up some terminology to avoid confusion.

A separated shoulder refers to an injury to the ligaments of the acromioclavicular joint (commonly known as the AC joint), which is the joint between the end of your collarbone and the upper part of your shoulder blade. It’s located near the point of the shoulder.

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Surgery For Shoulder Dislocation: When Can I Play Again?

In today’s article I’d like to provide some general guidelines about return to play after surgery for a shoulder dislocation. Your individual situation will be unique, based upon multiple factors so for specific guidelines you’ll need to discuss this carefully with your orthopedic surgeon. It’s also important to note that surgeons will have considerable variability in their personal preferences for return to play.

Here are the targets I will typically aim for:

Noncontact overhead sports, full swing golf, racket sports: four months
Pitcher throwing from the mound: six months
Full contact and collision sports: 6 to 9 months

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Unusual Procedure Stabilizes The Shoulder

Chances are you’ve heard of a young athlete with an unstable shoulder. And chances are that you’ve never heard of a surgical procedure called a “remplissage”. This unusual French name indicates a surgical procedure in which soft tissue is tacked down to the back of the shoulder inside the joint. It’s becoming increasingly popular as part of shoulder stabilization surgery for the young athlete, and is well worth a discussion with the surgeon.

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Shoulder Instability Surgery- Reliable Results For Most Athletes

I wrote last week about improvements in ACL surgery over the last 25 years and this week I’d like to explore improved results from another commonly performed sports medicine surgery- stabilization surgery for the dislocating shoulder. The results here mirror those of ACL surgery in many ways.

Many young athletes dislocate a shoulder from trauma, typically a dive with the arm outstretched overhead. This can happen in any sport involving that kind of motion, and any contact sport.

Most surgeries were performed through a large “open” incision 25 years ago, but nowadays can be performed arthroscopically in most cases. For uncomplicated stabilization of shoulders that have had a small number of dislocations from trauma, we should expect 90% of shoulders to remain stable and satisfaction rates upwards of 80% out to about 5 years with current methods, for recreational athletes.

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Coming Back From: Shoulder Separation (Egypt’s Eyes Are On Mo Salah)

This week I’ll offer up some pre-World Cup injury recovery info, inspired by Egypt/Liverpool brilliant playmaker Mo Salah. There’s been much speculation about the nature of Salah’s recent shoulder injury, and I haven’t been able to find a clear diagnosis in publicly available sources. But if I had to guess (and this is a pure guess), given the way the injury occurred and the evaluation from the physician in the accompanying photo, I’d say he likely sustained a shoulder separation.

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Rotator Cuff Repair For Young Athletes: An Uncommon Operation With Excellent Results

By Dev Mishra, M.D. President, Sideline Sports Doc Clinical Assistant Professor of Orthopedic Surgery, Stanford University Key Points: Rotator cuff tears requiring surgery are uncommon in young athletes Surgery typically leads to excellent function and very high return to sports at the same level or higher, although overhead athletes may need to change positions The…

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100 Innings
Overthrowing: Abnormal Shoulder MRIs In Young Baseball Players Without Shoulder Pain

By Dev Mishra, M.D. President, Sideline Sports Doc Clinical Assistant Professor of Orthopedic Surgery, Stanford University Key Points: A recent medical study showed that more than 50% of throwing shoulders in young baseball players without shoulder pain had MRI abnormalities These MRI issues have the potential to cause long term issues for the shoulder Players…

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Coming Back From: Shoulder Separation

By Dev K. Mishra, M.D. President, Sideline Sports Doc Clinical Assistant Professor of Orthopedic Surgery, Stanford University Key Points: A “shoulder separation” is a different injury than a shoulder dislocation The shoulder separation involves a sprain to the ligaments of a joint at the point of the shoulder near the end of the collarbone We…

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