Fall sports are back on the calendars of athletes, parents, coaches, and trainers. No matter whose team you are on, everyone wins when athletes stay injury-free. Each season, I team up with Edmonds high school athletic trainers on the sidelines to evaluate players on the field. I also see injured athletes in my clinic when additional assessment and treatment is needed.

When an athlete is in pain, the goal is always to get back to action quickly but with long-term results in mind. Most injuries are minor but more serious injuries can take longer to treat and heal. Two of the more notable injuries occurring in the young athletes I see are shoulder dislocations and anterior cruciate ligament (ACL) tears.

Shoulder Dislocation

Why it happens:
The shoulder joint has the greatest range of motion over all other joints, which also means it is the most prone to dislocating. The shoulder can dislocate when a player hits the turf without time to brace for the impact, or when reaching up and getting tangled in the arms of others, forcing the “ball” out of the shoulder socket.

How it is treated:

The shoulder is put back in place by the doctor or the athletic trainer on the field or on the sidelines, and the shoulder usually feels much better. However, further evaluation and treatment from a physician experienced in sports injuries is important to monitor progress, obtain appropriate imaging such as X-ray or MRI, and help guide the rehabilitation process.

Surgery is often performed to stabilize the shoulder by repairing the damage to the soft tissue and bone, especially if the shoulder dislocation recurs.  Most of the time, repair can be done through minimally invasive, arthroscopic methods.

After surgery, rehabilitation takes places over four or more months to further strengthen and stabilize the shoulder. A stable shoulder is also less likely to develop future problems such as arthritis.

Outcomes and Results:

Getting the right care at the right time is important for full healing. Shoulder dislocations should not be taken lightly. The chance of future dislocation increases with the frequency of dislocations. A first-time dislocation can turn into a recurrent shoulder dislocation if rehabilitation is not diligently followed and completed. Don’t take short cuts on rehab!

Anterior Cruciate Ligament (ACL) Tear

Why it Happens:
The anterior cruciate ligament (ACL) stabilizes the knee. If the ACL is torn, the knee is less stable during change of direction, leading to difficulty with sports such as football, basketball, and soccer. The ACL can be torn during a pivot move, often without contact. The excess knee shifting also can cause damage to other structures like cartilage surfaces and the meniscus, eventually leading to premature arthritis.

How it is Treated:
A torn ACL will not regenerate and heal itself; therefore, surgery is typically recommended to reconstruct the ACL. Taking tissue from other parts of the leg or knee, the tissue graft becomes the new ACL. The recovery process requires rehabilitation for several months to help the graft transition. A strong ACL relies on strength, reflexes and balance; focusing on these areas can help prevent further injury.

Some athletes try to rush through rehab, stopping as soon as the knee feels good. This can lead to ACL healing failure that could require additional surgeries to fix the ACL reconstruction. Focus on the long term win and complete the full course of rehab.

Don’t Stay Sidelined

Both shoulder dislocations and ACL tears can bring a false promise of feeling better initially, causing many to not seek further evaluation but then coming back to pain and injury.

Working with a provider trained in sports injuries can ensure an optimal return to the sport you love. Many players find they return to their former level or even better because of the sharpened focus on strength and mobility.

— By Jim Hsu, MD
The Polyclinic Orthopedics

Dr. Jim Hsu has supported the Edmonds School District high school sports for the past 15 seasons. He also sees patients at The Polyclinic Northgate Plaza and The Polyclinic Madison Center. He can be reached at 206-860-5578. Learn more about Dr. Hsu’s clinical interests at polyclinic.com/jim-hsu.