Shoulder Chagrin

Off the Cuff

Q: I am a 28- year-old police officer and have played softball without serious injury for 13 years. I have a small frame, but I'm tall and lanky. In a softball game last year I partially dislocated my left shoulder while sliding headfirst into base. That was it for the rest of the season.

When my partner and I recently arrested an angry, 6'3", 240-pound man, I dislocated the same shoulder and ripped the edge of the rotator cuff. An orthopedic surgeon told me there were two options. Either surgery to have my shoulder fixed permanently or a course of anti-inflammatories and exercise, which may not work.

The doctor said if I was shoved hard enough again, surgery was a must. I've heard a lot of horror stories about shoulder surgery and I'm frightened. I also have a heart murmur What should I do?

L.R.
Layton, UT

A: If a course of anti-inflammatory medication and physical therapy can relieve the pain and restore enough motion and strength for you to continue the rigorous demands of your job, it is certainly worth the time and effort. Most minor rotator cuff tears or dislocations respond favorably to this type of conservative treatment.

A minimum six-week course of physical therapy with particular emphasis on strengthening the front shoulder muscles would give you an indication of whether or not you can live without the surgery. If you feel improvement, continue the therapy for another three to six months.

The exercises will help prevent another dislocation, about which your surgeon has already warned you, and may allow other muscle groups to take over the action of the torn rotator cuff. However, if you have significant looseness in your shoulder or have two or more dislocations, surgery may be needed to prevent damage to your shoulder.

In a recent study of 45 athletes by the Kerlan-Jobe Orthopedic Clinic in Los Angeles, 87 percent of the patients undergoing rotator cuff surgery reported improvement of their shoulder, and 76 percent reported significant pain relief. However, 77 percent still had difficulty with throwing or overhead activity.

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