Playing through shoulder pain can cause problems down the road
You don’t have to be a professional athlete to know that participating in sports, particularly those that require repetitive overhead motions, can make you more susceptible to shoulder injuries. But what are those injuries and what can you do to protect yourself?
Douglass Stull, MD
“Shoulder injuries are commonly seen in baseball pitchers, but any athlete participating in sports that require repetitive overhead activity can be affected,” said Dr. Douglass Stull, a sports medicine physician and orthopedic surgeon with OrthoKansas. “Athletes who play softball, tennis, volleyball, swim or participate in track and field events – particularly javelin throwers – all have a higher risk of shoulder injury.”
If you notice pain that’s not going away, it’s time to talk with your primary care physician or schedule an appointment directly with OrthoKansas for an assessment. Some athletes may ignore and play through the pain, but that can cause more problems down the road. Common symptoms of a shoulder injury include:
- Deep shoulder pain with activity but improves with rest
- Lack of strength
- Feeling of a “dead arm” that doesn’t feel like it’s part of the body
- Decreased range of motion
Dr. Stull said he sees overuse injuries such as Little Leaguer’s shoulder in skeletally immature athletes. A skeletally immature (SI) person is one in whom the growth plates are still open. Overuse injuries such as labrum and rotator cuff injuries are more commonly seen in skeletally mature athletes. But there’s not a hard and fast age when it comes to skeletal maturity.
“Skeletal maturity happens sooner in females than males, so they won’t have SI injuries as late,” he said. “The most common age is between 11 and 13. As these athletes are going through puberty, muscles are getting stronger and the bones haven’t completely closed, so they’re adding new stress and power to a skeleton that isn’t completely mature.”
What should I expect when I visit the doctor?
At their first appointment, patients who turn to OrthoKansas for evaluation and treatment can expect to undergo a thorough examination.
“I want to know more about why the patient came to see me and about their goals. I also need to know the extent of use or overuse of the shoulder and any treatment that’s already been performed,” said Dr. Stull. “After I perform a thorough shoulder exam, I share the blunt truth with the patient, and their parents or coaches as needed, about overuse, various treatment options and the reality of return to play.”
Patients sometimes need an x-ray or other imaging to help determine the extent of the injury. The musculoskeletal (MSK)-trained radiologists with Radiologic Professional Services, a partner of LMH Health, have expertise in the subtleties of imaging specific to this group of athletes.
Todd Oberzan, MD
“Finding a problem when it’s subtle and early in the disease process can save a patient time – and sometimes intervention – so we can keep them at work, on the field, the golf course or just on a walk,” said Dr. Todd Oberzan, board-certified and MSK-trained radiologist.
Patients can benefit from the specialized MSK radiology training of Dr. Oberzan and Dr. Thomas Grillot. It provides them with the knowledge and experience to find the intricacies of disease and how it relates to the patient and their body.
“The beauty of having MSK-trained radiologists is their connection with orthopedics,” Dr. Stull said. “Dr. Oberzan looks at an image and we’re able to communicate about it and zero in on the problem. He has the benefit of reading the exam notes, and having access to all of the patient’s medical records.”
When you need the help of our MSK-trained radiologists, Dr. Stull’s team can schedule your appointment before you head out the door. The convenient, collaborative care provided at the LMH Health West Campus, including orthopedics, imaging and therapy, makes the campus a one-stop-shop for your medical care.
I’ve got a diagnosis. Are there non-surgical options?
There’s a misconception that when you see an orthopedic surgeon for help, you’re always going to end up having surgery. It’s important to remember that your doctor will exhaust conservative treatment options before discussing if surgery is appropriate for you.
Non-surgical treatment options include medication to reduce inflammation and pain, rest and physical therapy (PT). Part of PT includes an assessment of throwing mechanics and looking at the kinetic chain, with a focus on weakness and imbalances.
Dan Lorenz, director of sports medicine at LMH Health, said that your initial visit with a therapist includes a look at your shoulder, as well as your hips and knees too.
“In overhead athletes, force transfers from the ground up. Strong legs generate power through the torso, hips and spine, continuing through the shoulder. We look at your entire kinetic chain. Think of this as the parts of the body acting as a system of chain links and energy or force generated by one link is transferred to the next. If there’s a weak link, that causes your shoulder to overcompensate,” he said.
The therapist’s evaluation of the patient’s condition determines what exercises a patient will undertake and how long they can expect to be in therapy.
“Physical therapy isn’t a one size fits all solution. It’s individualized and specific to each patient based on their evaluation and history,” Lorenz said. “A college baseball pitcher may present differently than an adult who plays recreational softball. There may be common exercises between the two, but each patient is different.”
Surgery is on the menu
If medications and therapy don’t relieve pain and improve function, you may need surgery to repair an injury or replace a joint. Patients in Lawrence and around the region benefit from the experience and knowledge of surgeons at OrthoKansas like Dr. Stull.
“There are times when surgery is the route that’s best for the patient right off the bat,” he said. “Patients with gross instability of the shoulder as a result of traumatic injury and those with sudden tears of the rotator cuff aren’t candidates for physical therapy, so surgery is their best option.”
If surgery is in your future, it’s important to follow through with physical therapy to help improve your pain and function. Patients who’ve undergone surgery can expect to be in therapy for anywhere from 3-6 months.
“People that have the best outcomes following surgery are fully engaged and do what they’re supposed to do. If you’ve had surgery, expect to be in PT for 4-6 months. For patients who’ve had shoulder replacements, those demands can be less and it may only take 3-4 months,” Lorenz said. “If you follow through with your at-home program and your therapist’s instructions, that time may be shortened.”
The teams at LMH Health Therapy Services and OrthoKansas work closely to care for patients, with the clinicians, technology and facilities to provide care that’s not only exceptional – it’s among the best anywhere. Give us a call and let us help you get moving again.