Chicago, Ill. (June 22, 2009) – Third baseman Aramis Ramirez dislocated his left shoulder and was out six weeks.
The White Sox’ Dewayne Wise dislocated his right shoulder and missed six weeks.
But if an Illinois high school athlete dislocates his shoulder, he’s out for the season.
“It’s not just a season-ending injury, it’s often a career-ending injury,” says Dr. Tony Romeo. “That’s why every high school baseball, football, and hockey player lives in dread of dislocating his shoulder.” Dr. Romeo heads the Shoulder Service at Rush Medical College and is the Team Physician for the Chicago White Sox.
But Dr. Romeo has just published a new study that shows high school athletes can be treated just like the pros, with just a brief stay on the sidelines.
The standard treatment for students has been to splint a dislocated shoulder then go straight to surgery to repair torn ligaments and cartilage. That aggressive treatment is based on studies that show without surgery 95% of teens dislocate their shoulders again: surgery reduces that to 510%. The problem is surgical recovery takes a season-ending four months.
“Our study shows that’s absolutely unnecessary, “says Dr. Romeo. “We delayed surgery on 30 teen-age athletes until after their season. They did just as well after surgery as those who got immediate operations. They had some slippage in their shoulder joints while they played but it didn’t matter….and they didn’t have to stay on the sidelines.”
The orthopedic surgeon says delaying surgery is now possible because of new medical techniques that keep recently dislocated joints protected and immobilized. New neoprene
shoulder braces, for instance, keep the joint in place yet still allow complex motions such as throwing or hitting.
In addition, the age-old sling for immobilizing the shoulder joint is becoming a thing of the past. A sling immobilizes the joint by keeping the elbow against the hip and rotating the forearm inward. But recent studies suggest it’s far more effective to turn the elbow slightly outward. This position allows the shoulder’s injured ligaments to heal back into their proper position. In one study 30% of patients using a traditional sling had another dislocation; that compared to zero percent in patients whose elbows were rotated outwards.
Dr. Romeo says, “This coming year if I see a high-school athlete with a dislocation and there’s no nerve damage, I’ll put them in a brace for as little as a week or two then they’re right back in the game.”
Shoulder dislocations are particularly common in developing high school athletes. The injuries usually occur when the arm is outstretched e.g. arm tackling in football, or shooting a hockey puck. The shoulder joint is much like a golf ball on a tee; the leverage on an extended arm stretches the ligaments holding that “ball” in place and allow it to pop out.
“Traditionally players have been devastated,” says Dr. Romeo.“ But now they don’t have to be. Now we know they can safely keep playing. That’s the message we now have to get to trainers and orthopedic surgeons across Illinois.”
Dr. Romeo, who’s seen hundreds of high school athletes, knows just how meaningful that delay is. “These kids live for their sports, for their final years of competition. Now when I tell them their seasons don’t have to end, they have tears in their eyes.”
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