A shoulder’s movement is dependent upon a dynamic relationship of many muscle forces, ligament constraints, and bony joints. The shoulder has the greatest range of motion of any joint in the body which allows the athlete the ability to engage in a myriad of sports. However, this range of motion is not without risk. If any of the stabilizing ligaments or muscles in the shoulder are injured by trauma or overuse, the shoulder is at increased risk for injury. Shoulder injuries account for 8% to 20% of athletic injuries.
High School Level
Dr. Nicholson works often with athletes in this age group, aged 14-18, who either have an acute or chronic injuries. An acute injury, is the result of a trauma or impact that causes immediate or sudden pain. A chronic injury is an injury that has been slow in progress and persistent forseveral months or years without relief.
A common injury of the shoulder that Dr. Nicholson sees within this age group, are instability injuries. Often shoulder instability issues are caused by laxity within the joint which causes dislocations or subluxations. This becomes a chronic issue when it happens more than 2-3 times within a short period of time. When an instability event occurs, it is more likely to reoccur, especially before the age of 25. Dr. Nicholson works closely with young athletes to reduce the occurence of instability events with conservative treatment and bracing. Depending on the sport, he often waits until the end of the season if he believes it needs to be surgically repaired. It’simportant to know the damage, if any, of the shoulder with advanced imaging to ensure it is safe to wait for surgical treatment.
Dr. Nicholson appreciated an athlete’s desire to return to play quickly. His treatment philosophy balances that goal with keeping players safe and having them return to play with a restored ability to perform with speed and accuracy.
This age group competes at a much higher level of strength, endurance and speed than at the high school level. Dr. Nicholson often sees athletes who are from the area locally and attend Universities out of the area. The most common injury that comes into Dr. Nicholson’s office at the collegiate level are UCL tears. This injury is easily diagnosed with a physical examination and advanced imaging, such as an MRI or MR Arthrogram. Dr. Nicholson performs a UCL repair about once a month and treats about 20 UCL injuries in a calendar year. Not every UCL tear needs to be surgically repaired, but if an athlete wants to return back to overhead throwing sport, it’s the best solution to return to that competitive level. Dr. Nicholson and his team works closely with the athletes Athletic Training and Coaching staff to ensure we progress at a safe and tolerable level.
Professional and Competitive Level
Dr. Nicholson works with patients of all ages who compete at a high level outside of the High School and Collegiate level. Rotator Cuff tears are the most common injury in patients aged 40-60 years old. Dr. Nicholson understands the intricate details of repairing the muscle and the delicacy of physical therapy to be able to return to competitive sports safely and effectively.
Dr. Nicholson’s approach is to treat the patient, not the scan. It is a strategy that combines knowledge of the shoulder anatomy, an understanding of the pitching motion, and experience treating shoulder pain and injuries, and then individualizing treatment plans for each patient. These athletes return back to Iron Man competitions, Weightlifting Competitions, Professional Baseball, Club Sports and more.