Every day, with little to no thought, we ask our arms to carry a substantial burden and perform a multitude of tasks. We use them to perform mundane, repetitive tasks, from folding laundry to taking out the garbage, and expect high-level performance from them when we play sports like volleyball and basketball. The constant use that daily life requires of our arms can result in numerous injuries, and perhaps the most common is the shoulder injury.
It is estimated that in the United States, the annual incidence of shoulder pain addressed by Primary Care Physicians is 14.7 patients for every 1000—that translates to approximately 4,850,000 patients with some form of shoulder issue per year. Indeed, almost 10% of all high school athlete injuries are to the shoulder as are 10% of all work-related injuries.
Our Door Orthopedic Center works with patients from diagnosis to complete recovery, helping all our patients achieve their highest possible quality of life. At Door County Medical Center, we are proud to be Northeast Wisconsin's choice for every orthopedic need. The following is Jeffrey Albert's story, tracing his journey with the Door Orthopedic Center from initial shoulder discomfort and injury, through to his recovery.
Jeffrey grew up in Door County playing competitive sports. "I'm a big sports guy," he says, "Growing up, I loved playing any sport—football, basketball—you name it." And, Jeffrey's true passion was baseball; "I've loved playing baseball since I was around 5 years old. Pitching and shortstop were my two main spots. I just love everything about it."
In 2018, Jeffrey started to feel some discomfort in his shoulder, a discomfort that eventually progressed to pain. "I'm a competitor, so I tried to push through it. I wanted to be there for my teammates and give it all I had. At the time, I didn't really worry about the consequences."
But, as the discomfort and pain grew with each successive year, Jeffrey found that his performance, both on and off the field, was suffering. "My ability to play declined significantly," he recalls, adding, "Even doing common, everyday things was a struggle. By the time I was playing on the club team at UW Madison, I'd say I was at about 40% of normal. But again, I felt I just had to keep powering through."
"At a certain point," Jeffrey remarks, "you just have to admit to yourself that you can't keep going anymore—that you need to look for help somewhere else." So Jeffrey turned to Dr. Dan Tomaszewski and the Door Orthopedic Center at Door County Medical Center.
Diagnosing the problem
"I've known Jeffrey for a long time," Dr. Tomaszewski says. "His family is a big part of my family—he was my kids' babysitter for about 5 or 6 years."
"So, we were at a sporting event," he continues, "and I saw him trying to throw a football to my son and he was really struggling with it. Eventually, he came to see me with shoulder pain, wondering what was going on."
It turns out that Jeffrey had a torn labrum. "The labrum is a circular piece of cartilage that surrounds the socket portion of the ball and socket joint. It's kind of like a gasket that helps hold the ball in the socket," Dr. Tomaszewski says, adding, "A lot of times when people are athletes—baseball players, and specifically pitchers—they overuse their arms. That motion of bringing your arm back puts a lot of strain on the top of the shoulder, particularly at the labrum, and you can get tears just from overuse. And even a small tear in the labrum," Dr. Tomaszewski remarks, "has big consequences for folks who are vigorous athletes. If you are a competitive athlete, particularly one who uses their dominant throwing arm, a labral tear—as Jeffrey found out—is really debilitating."
The decision to get surgery
Initially, Jeffrey and Dr. Tomaszewski attempted physical therapy instead of surgery for two reasons: because historically, once a pitcher has a torn labrum, it is very difficult for them to return to baseball; and because surgery is a much more involved process. "We tried for quite a while to avoid surgery," Dr. Tomaszewski recalls, adding, "For several months, we tried physical therapy and other treatments because there is a significant downtime—recovery and rehab—associated with surgery, and we wanted to be certain that surgery was the right answer for him."
Unfortunately, the physical therapy didn't seem to work. In fact, Jeffrey's shoulder was getting worse. And, at that point, surgery became the only option. "I just wanted to be able to use my shoulder normally," Jeffrey recalls, "for everyday things, like picking stuff up. And, I'm only 22 years old right now. At some point down the road, I'd like to be able to play catch with my kids. So, looking into the future," he continues, "we decided to go with surgery—it was the right call."
Surgery, rehab, and the road to recovery
In order to repair Jeffrey's shoulder, Dr. Tomaszewski and the orthopedic team performed a minimally invasive, arthroscopic labral repair.
With arthroscopic surgery, the orthopedic surgeon makes several small incisions and inserts instruments—roughly the size of a ballpoint pen and that house a small camera and lighting system—into the incision. The surgeon is then able to see inside the joint and repair the injury without making a larger incision that requires the longer recovery time of open surgery.
With Jeffrey's labral repair, Dr. Tomaszewski put stitches in the labrum to repair it, and around the labrum to hold it back down to the socket. "When the labrum is separated from the socket," he remarks, "it's no longer doing its job—it's no longer acting to help hold the ball in the socket. So, putting the sutures in there can hold it to the bone so it can heal in a good position."
Following his surgery, Jeffrey began his rehabilitation program, of which there were three stages. Stage 1 lasted for 6 weeks while Jeffrey's arm was in a sling. During that time, physical therapists at the Door Orthopedic Center would stretch his arm for 30 minutes to an hour, thereby keeping the joint and surrounding muscles mobile. During stage 2, the sling came off and Jeffrey started to use the arm again—moving it and doing everyday activities. In the final stage of his recovery, Jeffrey began to work directly with physical therapists on building back atrophied muscle and regaining a full range of motion.
"Whenever I went to see physical therapists," Jeffrey remembers, "they were very encouraging and very optimistic. They'd say things like, 'Hey you can do this—power through.' Their encouragement was incredibly helpful," he adds, "because, some days you think, 'Do I really want to stretch my shoulder again or do this exercise 10 more times,' when you feel that, in the moment, it's not really doing anything—it just hurts." He continues, "Going in and seeing the physical therapy team at the Door Orthopedic Center, it was huge with regard to the whole overall mindset of improving myself and getting my shoulder back to 100%."
Of the entire surgery, rehab and recovery process, Jeffrey remarks, "I have no complaints whatsoever. The team at the Door Orthopedic Center were all awesome—from the anesthesiologist, to the nurse that helped me in recovery, to Dr. Tomaszewski doing the surgery, to all of the physical therapists that helped me progress through to recovery. Every person I worked with had a smile on their face every day—from the bottom up; they are all good people that you want to work with."
Advice for other athletes
"From my junior year of high school to my sophomore year of college, the biggest mistake that I made was to just deal with the pain—to just pick it up every day and try to play through it," Jeffrey says. "Once you feel any pain," he adds, "if it's in your leg, your shoulder, concussions, or anything, don't push through it—go ask for help. If I had said something right away, I probably could have avoided surgery."
Dr. Tomaszewski echoes that sentiment, "A lot of times, competitive athletes just really want to push it. That's the mentality; 'We just want to suck it up and get back in the game.'" He continues, "It's really not a great idea, especially when we're talking about the shoulder. There are injuries in the shoulder that, if treated early enough, won't require surgery. So, take care of it sooner rather than later—brushing it under the carpet doesn't make a lot of sense."
The Door Orthopedic Center at Door County Medical Center is a state-of-the-art facility paired with a top-notch orthopedic team that can get you back to daily living and your favorite activities as soon as possible. Our patients can expect exceptional outcomes—93% of our patients are discharged directly to their home, and The Door Orthopedic Center currently boasts a 100% overall satisfaction score.
To schedule an appointment at Door County Medical Center's Door Orthopedic Center, go to: https://www.dcmedical.org/medical-services/orthopedics/connect or call Door County Medical Center at 920-743-5566.