How a Shoulder Injury Can Be Treated Part 2/2

Ann Marie hurt her shoulder playing softball primarily. I do not think it was one specific injury that caused her tendon to fail. But what was most likely happened was an attritional or wear and tear type fraction from lots of practice, lots of games.
Rotator cuff injuries present in different ways. They could present with pain, often times pain is a symptom that is often times after the fact where the tendon has already torn. Some of the preceding symptoms or problems that patient may not notice beforehand is that they may lose velocity on their ball. They may not be able to last as long in a game if they're a pitcher. Outfielders may not be able to throw as far and they may feel like, historically has been called a dead arm syndrome. The athlete would come in and say, I just can't do it. A dead arm syndrome maybe over used, but it may be a harbinger or warning sign for the coaches and parents to say, are you throwing too much. Is that tendon being over loaded?
If a rotator cuff is completely torn in a young throwing athlete, we do recommend often to fix that. Usually it can be fix arthroscopically. And the reason we recommend fixing it is that if a tendon is torn off the bone, it tends not to repair on its own. Further more if you leave a torn tendon on its own and pulled away from the bone, that tendon gap or the hole that has been created from the tear over time will get bigger.
I assume from Ann Marie’s shoulder injury and the fact that she was taking care of a high level academic sports medicine center, that her shoulder was fix through an all arthroscopic technique. What has happened is arthroscope to view inside the shoulder joint. From inside the shoulder joint, we can see where the torn tendon is. Ann Marie’s surgeon were able to repair the tendons and pass anchors into the bone through which the suture can then be passed through the tendon and the tendon can be repaired or tied down to bone. The bones up above the shoulder can be remove, any spurs in the clavicle can also be remove.
The advantage of arthroscopic techniques is that the patient has less pain post operatively and we believe they have a quicker recovery.
Ann Marie comments at the end of her story that she may not be able to return to sports completely. And return to a high level of participation. This is unfortunately one of the bad parts about this injury. The goals of surgery, to repair a tendon, should be to alleviate the patient’s pain and return function. Whether or not the patient can return to a full high level demanding activities such as throwing from the outfield is determined on whether or not the repair is from a small tendon or a massive tendon.
Our experience has been that return to high level sports, patients are often times not able to get back to the pre injury level sports they were at. They should be able to get back to functional day to day activity without pain.


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