STAMFORD, Conn. -- As the NHL playoff push begins this month, and adult and youth hockey leagues enter the home stretch, injuries can make or break a team during postseason time.
Three of the most common shoulder injuries for hockey players are acromioclavicular (A-C joint) separation in the shoulder, clavicle fractures, and shoulder dislocations. HSS orthopedic surgeon Dr. John MacGillivray discusses these injuries and the treatments available to get players back on the ice.
A-C joint separations are commonly caused by players getting checked into the boards, resulting in an injury to the ligaments that stabilize the A-C joint. Wearing hockey shoulder pads can help but not necessarily prevent these injuries, especially if a player is checked with enough force. Most joint separations are treated non-operatively with physical therapy, anti-inflammatory medications or sometimes corticosteroid injections. However, some of the more displaced or misaligned joints may require surgery. A player can resume playing once the pain has subsided.
Like A-C joint separations, Clavicle fractures are often caused by being checked into the boards. Treatment is based on several factors including the amount of displacement, shortening -- when the two broken bone-ends overlaps -- and the number of fractures in the bone. Surgery is recommended if there is a fair amount of displacement, shortening of more than one inch, and if the fractures break the bone into more than two pieces. Treatment consists of wearing a sling for four to six weeks and a return to play in three to four months.
Shoulder dislocations occur when the shoulder ball pops out of the socket, which usually requires a trip to the emergency room to reposition the shoulder. A first-time dislocation is often treated with physical therapy to strengthen the shoulder. If more shoulder dislocations occur, arthroscopic shoulder stabilization surgery may be warranted.
This minimally invasive surgery involves fitting cameras and instruments through tiny incisions in the shoulder to view and repair shoulder structure.
Dr. John MacGillivray is a sports medicine surgeon at Hospital for Special Surgery and has developed new techniques for shoulder repair and ligament reconstruction of the knee. He practices at both the HSS Outpatient Center in Stamford and the hospital’s main campus in New York.