Sports Safety

By Abbott Kagan II, M.D.

__Living in Florida, one need not travel far to find an excellent course, as this state is truly a golfer's paradise. I have had the privilege to oversee the medical care of many avid golfers during my 22 years of practicing orthopedics. __One very common area of injury for the golfer is the shoulder.
__As a golfer, you know that a good golf swing revolves around a good shoulder turn. Years of golfing can cause stress on the shoulders, which are the most flexible and versatile joints in the body. Capable of a wide range of motion, our shoulders are used in almost every activity. Consequently, the shoulders are susceptible to many different types of injuries and problems. Some of the most common shoulder problems are the result of simple wear and tear.

Three Symptoms of Shoulder Pain in Golfers

STIFFNESS
__In some cases, a stiff shoulder can be caused by Osteoarthritis or by a frozen shoulder, otherwise known as Adhesive Capsulitis. A lack of flexibility in the muscles surrounding the rotator cuff will also lead to stiffness in the shoulder. This can be treated by range of motion exercises, flexibility, and gentle stretching.

PAIN WITH GOLF SWING
__If you feel pain during your swing, it could be related to improper biomechanics. The first step is to determine where and when the pain comes into play. Does it happen on the backswing, contact or follow through? Pain with a golf swing could be caused by tendonitis, bursitis, impingement, or rotator cuff strain. If your shoulder is inflamed (bursitis/tendonitis), this could be treated with nosterodial anti-inflammatory drugs. On top of that, it is recommended to apply ice and maintain a range of motion. Therapeutic ultrasound or cortisone injections may also be necessary. If the rotator cuff is strained, it can be treated with strengthening exercises, ice, etc.

SHOULDER INSTABILITY
__An unstable shoulder can be caused by weak rotator cuff muscles, which can generally be treated with strengthening exercises using an elastic band with light weight no more than five pounds. The successful treatment of a shoulder problem depends on an accurate diagnosis by your doctor, who will first need to know the history of your problem, including a description of your pain or discomfort and how long you have had the pain.
__While arthroscopy is used more frequently with knee injuries, it is becoming an increasingly used method of diagnosing and treating the problem shoulder. Arthroscopy is a surgical technique which allows your doctor to diagnose and treat a problem or damaged shoulder without making a large surgical incision in the outer skin that protects the shoulder joint.
__How Long Does the Surgery Take? As the wise old orthopedic surgeon once said, the time it takes to do the operation is the time it takes to do it right! Usually, about an hour and a half gives us the time to position you for the surgery, wash your shoulder and prepare the skin for surgery, do the operation, wake you up, and move you to the recovery room.
__How Bout That Therapy Doc? I always tell my patients that there are two parts to the operation. The first is the part that I do, and that usually finishes when they leave the hospital. The second is the part that they do, and that begins the moment they wake up. You need to start moving your shoulder immediately with gentle range of motion exercises, as well as using your arm for normal activities of daily living. This would include feeding yourself and helping yourself get dressed. It is very important to start the therapy early and to do it diligently until it is completed and end results are met, otherwise the result of the operation will not be as good as either you or I would like to see.
__When will you see the Doctor again? Most patients with total shoulders will be seen in the office between seven and ten days after surgery. At that time the Doctor will evaluate your wound and possible remove your staples or sutures.

Originally printed in the Summer 1999 issue of Golf Coasting.