With Seattle Seahawks receiver Sidney Rice’s damaged labrum in his shoulder a hot topic this week, I thought it would be good to reach out and talk to someone who could shed some light on how athletes with similar injuries deal with this situation.
Colvin’s expertise is sports medicine. Her clinical and research interests include surgical treatment of knee, shoulder and hip disorders. Dr. Colvin serves as a physician for the United States Tennis Association during the U.S. Open, providing orthopaedic care to elite players, and as served as a physician for the New York City Triathlon.
Now, Dr. Colvin has not examined Rice’s shoulder and does not speak specificly about his injury, but just in general terms of how teams deal with athletes who have a similar injury as Rice does.
Q: There’s been a lot of discussion about the different levels of instability involving a labrum tear in a shoulder, and how some players can continue to play while others need surgery. Can you discuss the process doctors go through in making that determination? And if a player avoids surgery, what are the tests that he or she needs to pass in order to get the okay to return to playing?
Dr. Colvin: “You can think of the labrum as sort of a bumper in his shoulder. The shoulder is a ball in a socket, and the labrum lines the socket part of the cup. And it keeps the ball inside that cup.
“So you can imagine that if you have a big tear in that bumper, it’s going to be a lot easier for your shoulder to pop out of place than if you just have a small tear, because more of the bumper is destabilized.
“So if someone’s shoulder is coming out when they’re just doing things like trying to put a coat on or reaching for something in a closet – something where it’s coming out when they are just doing regular, every day activities – we typically recommend doing surgery early to stabilize the shoulder and prevent any further damage to the cartilage or other things that could get ruined in the shoulder.
“Occasionally you can dislocate your shoulder and only have a small tearing of the labrum, or stretching of it. And you can certainly try to rehab the player and have them work on strengthening the muscles around the shoulder, and see if they can go back to playing. So that’s a situation where you don’t need surgery right away.
“And you don’t have to completely dislocate the shoulder. You have the ball and the cup, and either the ball can completely pop out of the cup, or it can just come out of it part of the way. That’s called subluxation of the shoulder. So what can happen is that also damages the labrum, but the tear is not significant enough to cause the whole ball to pop out.”
Q: What are the risks of playing with the injury in terms of contact and the possibility of further damaging the shoulder?
Dr. Colvin: “Certainly you can re-dislocate the shoulder and have it come out of place again. And whenever that happens, you can tear the labrum further. Or there’s cartilage that coats both surfaces of the shoulder on both sides, and so sometimes that can scrape, if can imagine that things are sliding back and forth around it. So those are probably the more common things that could happen.”
Q: Are there limitations to what a player can do in terms of his catch radius and being able to extend for passes?
Dr. Colvin: “It really depends on where the tear is. So the labrum goes 360 degrees around the cup. And you can dislocate or subluxate the ball in every single direction possible. So it really depends on the specific location of the injury.
Q: Ultimately will a player with this injury require surgery?
Dr. Colvin: “It really depends on if he’s able to play and it doesn’t dislocate on him or sublux on him, then not necessarily. It could be that small of a tear that it doesn’t bother him again.”
Q: So it could be small enough to where it heals on its own?
Dr. Colvin: “No, it will never heal on its own. It will scar down, but it’s not going to be the same as if he never damaged it. But he would be treated just based on his symptoms. So he’s not coming out of place, then there’s not necessarily a reason to fix it if the shoulder’s still pretty stable.”
Q: Whether a player has surgery to fix the issue or plays with the injury, what are the risks of the injury reoccurring?
Dr. Colvin: “There’s always a risk that it can come out place again. He’s in a collision sport, so that’s a risk no matter what.”