Interviewer: Hi, everyone. Happy Friday. My name is Alli, and I’m here with one of our Florida Orthopedic Institute shoulder and elbow specialists, Dr. Mark Mighell. How are you tonight, Dr. Mighell?

Mark: I’m doing great. Thank you so much. It’s great to be out here. We’re out here at Gaither High School, and this is going to be one of the rivalries between Gaither and Plant High School, and we’re here to talk a little bit about sports injuries tonight.

Interviewer: Yes, we sure are. Dr. Mighell is the official team physician for Plant High School. We’re wishing the best of luck to all of our student-athletes tonight. Wishing them a safe and successful game. Good luck to all of our teams this evening. First, up for our Friday night topic, we’re going to talk about shoulder separation and instability. First up, what is shoulder separation and instability, and does these influence each other? Can you tell us about that?

Mark: This is a really good question that I think a lot of people don’t really understand. They’re completely different problems. When we talk about a shoulder separation, that’s where your shoulder blade gets impacted down, oftentimes from a vicious tackle, a return, and it separates the shoulder blade from the collarbone. This injury, while it is pretty dramatic and painful, allows the athlete in most cases to make a recovery. Usually, we can return them to the field within four to six weeks unless it’s a very severe one that we call a type four or five. Those are the rare ones that sometimes require surgery. In general, for the athlete, this will allow them to return to play. Shoulder dislocations are very different. You asked me about those. A shoulder dislocation is when the ball actually comes completely out of the socket. When the ball comes out of the socket it’s usually another very dramatic injury and the arm can go numb. The athlete is usually on the field in a lot of distress. When the team comes out, the athletic trainer, the coach, myself, to evaluate the athlete. If we’re lucky, sometimes we’re able to reduce or put the ball back into the socket actually on the field, but if you wait too long, with the spasm that occurs it becomes very difficult. Then you have to take the athlete to the emergency room where they’re given medications that will relax their muscles, make them more comfortable, allow them to actually have the provider in the emergency room reduce the shoulder. Once you have a shoulder dislocation, though, oftentimes it’s very difficult to return to play. For a lot of the athletes, this can be a season-ending injury for them. That’s really tough, and a lot of times these kids only have one or two seasons that they can play high school football. If they do get one of these dislocations they can tear the lining off of the socket, and when that happens it can actually require a surgery where we go in arthroscopically, so we use a small fiber-optic camera, we go in the shoulder and we see this, and we put little anchors which are tiny little screws that are made of plastic into the shoulder.

Interviewer: Can you mention and shed some light on what is the care process, and how do we get these student-athletes back on the field?

Mark: We have a regimented, we have a protocol. Once the athlete has the dislocation they usually come back to the office and they’re in the sling. The sling will be worn for a period of two to three weeks to allow the soft tissues to recover. Then we have to make a determination whether we want to try a very aggressive therapy program to rehab the shoulder to allow them to return to play versus surgery. Oftentimes we get a special study called an MRI scan. An MRI scan will allow us to better visualize the actual injury itself and can guide us in treatment as to whether this is a surgical case or a non-surgical case.

Interviewer: Finally, if a student-athlete is injured with a shoulder separation, can they get back on the fields and play at the same competitive level that they were playing at before the injury?

Mark: Actually, this is an injury that if you can fix it and you wait, and the waiting period after surgery is about nine months, so that will eliminate them from that season of play. They can get back to the same level of play if they have the surgery.

Interviewer: Thank you guys for tuning in, and thank you, Dr. Mighell, for talking about this with us. Again, good luck to our student-athletes. We hope everyone has a great weekend, and stay safe this weekend. Thank you, guys.

Mark: Thank you, and I appreciate you interviewing me, and congratulations to Plant High School. Hopefully, this is a great year. It’s always great to be out with the kids on a Friday night.

Interviewer: Thank you.



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