Why did you choose to specialize in orthopedics?
I have always enjoyed fixing things. I could look at something mechanical and it made sense to me. Orthopedics involves a lot of mechanical concepts and physics and this made it the natural fit for me. Now, I get to help people and fix their problems.
You take care of all types of orthopedic problems, but one of your main specialties is the shoulder. Why?
The shoulder has the widest range of motion of any joint in the body. To accomplish this, it is a complex arrangement of bones and soft tissue. When I was in training, it seemed to be the joint that most surgeons had difficulty dealing with, which made me want to focus my attention on mastering it. Many of the activities people enjoy during the summer, such as golf, tennis, baseball and water sports can put stress and strain on our shoulders.
What steps can we take to help prevent shoulder injury?
Well, with a cold and wet winter and spring like we have had, a lot of people are not as active and when it is finally nice outside, people are eager to hit the ground running. If you have not been as active or participated in a sport for a while, you should ease back into it appropriately and give your body time to acclimate to the activity you are planning to do. In addition to getting your body up to speed, you should always stretch and warm up before participating in an activity, particularly as we age.
Are there specific exercises you recommend to help strengthen the shoulder?
The biggest problem I see in regards to strengthening the shoulder is people focus more on what we call “beach muscles”. The rotator cuff muscles help the shoulder function properly, and most people do not take time to strengthen them as they should.
This can be done with light weights and high repetitions, using equipment like Thera-Bands or cable pulleys.
What types of shoulder injuries are common during the summer months?
As the weather gets nice, people increase their outdoor activities. I see a lot of cycling injuries, where people crash and fly over the handlebars and land on their shoulder and fracture their clavicle or injure their AC joint. There are lots of overhand sports injuries, such as swinging a tennis racquet or throwing a baseball. Overuse injuries of the shoulder and elbow have become a major problem because kids these days play baseball year-round and their arm never gets a rest. Responsible parents and coaches can help this by watching pitch counts and making sure that young players are given adequate rest time between throwing. Luckily people are becoming more aware of this now and hopefully this will help the epidemic we have seen in baseball players. Also, something as simple as playing multiple sports allows your body to change the major muscle groups that are getting overworked and get a much needed rest. I also see multiple injuries each summer involving the rotator cuff and labrum that occur while waterskiing or tubing. Finally, people see swimming as a good, low impact way of staying in shape, which it is, but it can put stress on your shoulders if done too much or improperly, causing impingement.
If we feel our shoulder is injured, what steps should we take?
Usually rest and anti-inflammatory medications are a good first step. If it fails to improve, then it is probably a good idea to have it looked at by an orthopedic surgeon to see if there is any cause for concern. Luckily, most of the aches and pains in the shoulder can be treated conservatively with medications or injections, but the problem I worry about the most is chronic rotator cuff tears that people neglect too long before seeking medical care. You can have a tear and not even know it until it is too late because it did not cause any discomfort or it only seemed minor. Unfortunately I see this almost daily. That is not to say there is nothing that could be done at that point; however, the options for treatment are more limited.
How do you evaluate shoulder injuries and problems?
Usually age and symptoms narrow down the probable causes considerably. Clinical exam, x-rays and MRI if needed will provide the right diagnosis.
What do you see in the future related to shoulder injury treatments?
Most procedures today can be done arthroscopically with a small camera and instruments as an outpatient. Healing and biologics are a hot topic. I am sure many people have heard of stem cells and PRP (platelet rich plasma), and while they do have an application in some shoulder problems, they are still experimental. The key is deciding when those are an option. Unfortunately, I see people who are mislead into believing that some of these treatments can cure anything, and that’s simply not the case. People should be very leery of anyone who guarantees that something is going to fix their problem, especially some of these experimental treatments.
What are some of the summertime activities you enjoy doing?
I love being outside. I play outside with my kids, wife, and dog a lot. We love going to the lake. I wakeboard and surf, but mostly just hang out with family and friends!