SHOULDER INSTABILITY & ICE HOCKEY:
Shoulder dislocation and instability are not uncommon injuries in ice hockey from the PeeWee level to Men’s League hockey to the NHL. Dr. Rudzki has experience with these injuries from research and co-authoring book chapters with world experts to lecturing internationally and from collaborating with colleagues on comprehensive return-to-play protocols to an extensive volume of surgical and non-operative treatment and rehabilitation. Ice hockey and shoulder instability are commonly connected and with careful, thoughtful treatment players can return to the highest possible level of play.
At the time of his shoulder dislocation in October of 2016, this patient was an active, healthy, 14-year old male ice hockey athlete playing on a Tier 1 team. In January of the same year, Dr. Rudzki treated him conservatively for a midshaft clavicle fracture that healed uneventfully. However, a shoulder dislocation is an entirely different injury for an athlete under 20 years of age. His shoulder injury required an immediate reduction in the emergency room in New Jersey. As soon as he was back in Washington, D.C., he came in to our office for a consultation.
Dr. Rudzki has done research and presented lectures (i.e. Primary Shoulder Instability, London) on the outcomes of shoulder instability injuries in young athletes when treated surgically verses with conservative management. In this patient’s case, as a male athlete under the age of 15, his risk of reinjury was greater than 95% without surgical intervention.
The patient’s MRI of the right shoulder demonstrated an anterior inferior labral tear with a Hill-Sachs lesion.
Dr. Rudzki and the parents discussed a plan for surgery, which unfortunately had a brief delay due to other factors. In the interim, the patient sustained yet another shoulder dislocation in March of 2017 and arthroscopic shoulder stabilization surgery was scheduled for April at the Bethesda Chevy Chase Surgery Center.
The patient underwent an uneventful arthroscopic stabilization in which the shoulder is repaired with a high-definition fiberoptic video camera through one of three small incisions less than 1.5 cm. The labrum and ligaments are repaired with high-strength non-metallic anchors and braided suture to recreate the native anatomy and restore stability to the shoulder.
The patient was in a sling for six weeks after surgery to immobilize the shoulder and protect the repair. After the first four weeks, the patient began physical therapy to help restore range of motion and strength in the extremity. At 6 months, patients are cleared to resume contact/collision sports. Dr. Rudzki has a specific interest in focused rehabilitation protocols that not only enable athletes to return to their sport, but to do so with a goal of being able to excel and with a minimal risk of re-injury. This requires careful follow-up, thoughtful collaboration with patients/families/physical therapists/coaches, and a specific program to minimize loss of core strength, lower extremity strength and power, and to optimize physical conditioning.