Surgery for shoulder injury? Depends on your priorities

Q: I recently fell off my bicycle and injured my left shoulder. I experienced severe pain, limited shoulder motion, and a bump on the top of my shoulder.

I went to an orthopedic surgeon, who recommended surgery for a separated left shoulder. The pain is now less and I can move my shoulder pretty well. The bump is still present.

I really do not want surgery unless I absolutely have to do it. What are the advantages to surgery, and is there a nonsurgical option?

A: There are two major joints in the shoulder. The ball and socket glenohumeral joint is mostly responsible for shoulder stability and range of motion. The AC “acromioclavicular joint” is where the collar bone attaches to the top of the shoulder blade.

When injured there are two pair of ligaments that can tear. A grade 1 sprain is a microtear of the ligaments, and a grade 2 sprain is a partial tear of these ligaments.

Grade 1 and 2 injuries are treated with a sling for comfort and rehab. Grade 3 AC injuries result in complete tears of both ligaments. The injured athlete will notice a prominence of the collar bone and pain.

In an elite athlete or laborer, surgery to repair the ligaments may be the best option. Someone who is concerned about symmetry of both shoulders or cosmesis may also be a surgical candidate.

Since you are feeling better and have a good range of motion you may do well without surgery and with a proper physical therapy program.

However, the bump you have will be permanent without surgery. I recommend you get a second opinion from another orthopedic surgeon so you can further discuss your options.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to HarlanS@baptisthealth.net