Even young, healthy athletes can be at risk of shoulder injuries.

Earl Brewley, MD, is a shoulder and elbow surgeon with Salem Health Orthopedics. Dr. Brewley said there are certain circumstances where those injuries require surgery. Usually, that’s a dislocation or labrum tear.

“A dislocation happens when a contact or collision athlete has a forceful movement of the arm that causes the shoulder to come out of the socket,” he said. “Labrum tears stem from the shoulder joint where part of the tendon attaches to the socket portion. With repetitive overhead movement, you can have damage to that area.”

Athletes at risk

Dr. Brewley said he sees most dislocations with wrestlers, football players and hockey players. Labrum tears are more common in swimmers and baseball pitchers. So, when is surgery the best tool for recovery?

“You have to think about return to sport,” Dr. Brewley said. “If someone with a shoulder dislocation has this injury for the first time, surgery can be controversial. Some say if they want to return to the sport, fix them. The most important thing is early evaluation so you and your doctor can make the best-informed decision.”

Shoulder dislocation and surgery

The orthopedic surgeon said surgical intervention is a good idea when dislocation causes bone loss or if this is a repeat injury.

“If you’re having recurrent dislocations or feeling like the shoulder is going to pop out, then you can be more aggressive with treatment if you want to return to sport at the same level,” said Dr. Brewley.

Labrum tear treatment

With labrum tears, the surgeon said he starts with tools like cortisone injections and physical therapy.

“Usually, labrum tears are tough because if you’ve been an overhead thrower, sometimes you can overtighten the shoulder and they may not be able to return to the same level,” said Dr. Brewley. “So, typically, that would come after conservative management, rehabbing the shoulder.”

The surgeon notes for some athletes, these kinds of injuries can be hard to avoid. He recommends strength training and preventing risky overhead arm positions to lower the likelihood of getting hurt.

But Dr. Brewley said if surgery is the best step, he’ll work collaboratively with his patients along the way.

“We personalize the treatment,” he said. “The sports medicine surgeons here want to build trust in the community.”

Orthopedic care

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