Playing Can Worsen Damaged Shoulder

A recent article in the Seattle Times highlights some relatively common but little talked about issues in sports. The first issue is the relationship of shoulder arthritis to a shoulder dislocation or instability. As the most mobile joint in humans, the shoulder is also the most commonly dislocated and unstable joint. Just as driving your car out of alignment results in premature and asymmetric wear of the tires, an unstable shoulder with time and repetition significantly increases the risk of developing shoulder arthritis at shoulder sports injuryan earlier age.

Click here to watch a video about Damaged Unstable Shoulder.

Colin Porter, a starting guard for the Washington football team the last two seasons, knew the nagging pain in his shoulders was only getting worse. In the Arizona game last year, his left shoulder popped out five times.

But the Bothell High grad figured that off season surgery would fix the problem.

Instead, surgery on each shoulder in recent months revealed degenerative arthritis and a recommendation from his doctor that Porter give up football. This week, Porter — who would have been a junior next season — made the decision to stop playing.

Porter said he first began having shoulder problems in the ninth grade, but never had a surgery until January.

“I was always able to play with them and able to play with the pain,” he said Wednesday. “But it got to a point this year that I needed to get them done, and I didn’t know it would be that bad. Thought it would just be a little repaired labrum on each shoulder. But it turned out to be a lot, lot worse.

“… I’m 20 years old with these problems and I’ve got a lot of life ahead of me and with these problems already, it could be a hard road ahead of me with my shoulders as is, and if I kept playing it would be even worse.”

Porter’s departure is a significant blow for the Huskies as he was expected to help anchor the line and be one of four projected returning starters. Instead, UW has been hard hit up front with Porter gone and fellow starting guard Colin Tanigawa recovering from a knee injury suffered against Oregon State with no return date set.

Porter will stay in school on a medical scholarship and finish a degree in political science and international security.

While some talked of Porter having an NFL future, he said that was never a specific goal and that he had always hoped to pursue a career in the military or intelligence. He said that’s where he will now turn his focus instead of looking back on what might have been.

“I consider myself lucky to even get the chance to play Division I football, let alone be able to start and be a contributor and a contributor to team success,” he said. “Not everyone gets two years, or even gets any chance to do that. So I consider myself lucky. My career was stopped short of the four years it would have been, but not everyone gets the chance that I got, and I’m thankful for that.”

http://seattletimes.nwsource.com/html/huskyfootball/2017961024_porter12.html

The second issue is that surgery by itself at an earlier stage isn’t necessarily a solution. As we have come to learn more and more about how the shoulder works, it has become increasingly clear that the shoulder functions in a circular or global manner, meaning that most often a problem on one side of the globe will most often have some associated or complementary effect on the opposite side of the globe. So although many surgical procedures have been succesful at reducing dislocations, because they created an imbalance in the circle, also contributed to developing instability in the opposite direction or increasing the risk of developing arthritis by not fully restoring global balance. This is similar to replacing worn tires on your car without addressing the core problem of alignment, which will ultimately result in premature wear of the new tires. So to avoid a failed shoulder surgery and reduce the risk of further damage, it is not only important to get early treatment, but to make sure and get comprehensive treatment and pick a shoulder specialist that understands the global balance of the shoulder. 

Click here to watch a video about Shoulder Surgery Complications.

The last issue is one of competing priorities. Colin Porter knew he had hurt his shoulder as early as the ninth grade, but because he could play with the pain, he felt that he could just wait to address the issue later. No one wants to miss time because of an injury-most coaches, trainers, parents, and athletes believe that “no pain, no gain” builds stronger athletes and ultimately stronger people. Unfortunately, as this case illustrates, the challenge in life is to try and use as much real and meaningful information as possible to guide our decisions and be able to tell the difference between the pain of growth and building from the pain of injury and destruction.

Author
Vivek Agrawal, MD

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