Shoulder injuries in young athletes are very common and can vary in cause and severity depending on each individual athlete’s training schedule and what sports they are playing. An estimated 120,000 sports-related shoulder injuries occur in high school athletes each year, and shoulder surgeries account for about 10 percent of all surgeries performed on high school athletes.
With lots of high contact sports (football, soccer) and overhead sports (volleyball, tennis) occurring in the fall sports season, there is a greater risk for traumatic shoulder injuries to occur. Here are some of the most common traumatic shoulder injuries:
Shoulder dislocations and subluxations (a partial dislocation) account for about 25 percent of shoulder injuries in high school athletes. These injuries are usually cause by direct contact or significant force being places on the shoulder. First-time dislocations will often be X-rayed prior to relocation to rule out a fracture. Then a physician will put the shoulder back into place and immobilize it for a period of time. Rehabilitation to restore range of motion and strength are commonly required prior to returning to activity. Surgery may be necessary if a cartilage or bony injury also occurred or if repeated dislocations or subluxations occur.
Collarbone (clavicle) Fractures
Clavicle fractures can be caused by direct impact, falling onto the shoulder or falling on an outstretched arm. In young athletes, the bone doesn’t usually break all the way through. Pain, swelling or deformity can occur with clavicle fractures. X-rays will be taken and the patient may be put in a sling or brace for up to eight weeks to allow the bone to heal. Rehabilitation will help restore range of motion and strength prior to return to activity. Surgery may be needed if the fracture caused the bone to move significantly.
A labrum tear can occur from falling on an outstretched arm, direct impact, or excessive force being placed on the shoulder joint or as a result of dislocation or subluxation. A popping, clicking or catching sensation with pain can be felt in the shoulder. Episodes of instability with shoulder movement may occur as well. In active people, surgery is almost always required for serious labrum tears. Athletes usually return to sport activities in 4-6 months.
Acromioclavicular (A/C) Joint Sprains
A/C joint sprains occur as a result of either a direct blow to the top of the shoulder or from falling directly into the shoulder. Classic symptoms of an A/C sprain include significant pain at the top of the shoulder that increases when the shoulder moves. Moving the shoulder across the front of the body will be especially painful. A period of immobilization in a sling is normally required until pain and swelling decrease. Then range of motion and strengthening exercises can begin, followed by a gradual return to sports.
If you’re concerned your student athlete has a shoulder injury, contact our Sports Medicine department at Nationwide Children’s Hospital at 614-355-6000 to schedule an appointment.
Margaret (Maggy) Rule, MS, AT, ATC is an athletic trainer in Sports Medicine at Nationwide Children's Hospital. Upon graduation from Purdue University, Maggy served as an assistant athletic trainer at Fredonia State University in Western New York for a year before coming to Nationwide Children's.
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