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Sports Medicine | Mar 24, 2018

Shoulder injuries in young athletes are common, with American football, soccer, and hockey players seeing the most impact driven injuries. Baseball, volleyball, and tennis players as well as gymnasts and golfers may also end up with shoulder injuries due to repetitive movement. Many shoulder injuries will resolve with proper care, rest, and a slow reintroduction to training, but in some cases surgery is unavoidable.

Labrum Tears

Labrum tears typically are caused by a fall onto an outstretched arm, a direct impact to the shoulder, excessive force being placed on the shoulder, or as the result of a severe shoulder dislocation or partial dislocation.

  • Athletes most at risk for labrum tears are those involved in impact sports such as football, hockey, or soccer; baseball pitchers are also at risk.
  • Symptoms include significant pain in the shoulder accompanied by a popping, clicking, or catching sensation; occasionally, instability with shoulder movement may occur at intervals.
  • Surgery is almost always required for serious labrum tears, and even young athletes in good health can expect a 4-month to 6-month recovery time before they are cleared to return to sports activities.

Rotator Cuff Injury

Rotator cuff tears typically are caused by repetitive motions, such as an overhand throw or swing.

  • Athletes most at risk for rotator cuff injury include baseball and tennis players, weightlifters, and rowers – all of whom use significant rotation of the shoulder to achieve their goals.
  • Symptoms include pain in the shoulder and arm; this pain is often worse at night. Overhead movements cause the pain to worsen, and the shoulder may become weak and unstable.
  • Surgery is indicated for chronic rotator cuff injury that refuses to respond to alternate treatments.

Collarbone Fractures

Collarbone or clavicle fractures can also be caused by direct impact or falling onto the shoulder, or by simply falling on an outstretched arm. In many young athletes, the bone does not break all the way through. After X-rays are taken a sling or brace is normally required for up to eight weeks during healing, after which rehabilitation is required to restore range of motion before the athlete can return to activity.

  • Athletes most at risk for collarbone fractures are those involved in impact sports, or who may experience falls (horseback riding, skiing, etc).
  • Symptoms include shoulder pain and swelling; possible deformity from out of place bone.
  • Surgery may be needed if the clavicle fracture has caused significant displacement of the bone, or of the bone fractures completely or in multiple places and requires surgery to realign the clavicle.

 

Shoulder Dislocations

Shoulder dislocations and partial dislocations (subluxations) represent around 25 percent of shoulder injuries in high school athletes, and are primarily caused by direct, forceful impact on the shoulder (either from contact with another player, or as a consequence of a fall). First-time dislocations are normally X-rayed to rule out a fracture, then relocated and immobilized. The younger the athlete, the more likely a dislocation of the same shoulder will reoccur – the chances of re-dislocation in athletes under the age of 25 is up to 90%.

  • Athletes most at risk for collarbone fractures are those involved in impact sports or overhead sports (gymnasts, wrestlers, volleyball players, etc)
  • Symptoms include shoulder pain and deformity from out of place joint; the swifter the relocation, the less swelling there will be.
  • Surgery may be necessary if a fracture of the bone or cartilage has occurred, or if osteoarthritis sets in after repeated dislocations or subluxations.

Orthopaedic surgery on young athletes has a high success rate, and most can return to playing sports recreationally or competitively.