WhiteCoat

Johnny Floppy Shoulder

My son wrestles.

We were at a wrestling tournament most of the day today. At the tournament, one of the other members of his team was losing a match and then suddenly complained of shoulder pain. Immediately, several people said that his shoulder looked deformed and then assumed that he had dislocated his shoulder. Another wrestler ran over to get me.

By the time I got over to the mat, he had finished the match and was crying and holding his shoulder. Someone had stated that a trainer had “pushed his shoulder back into place.” The kid was moving his arm around fairly well and wasn’t splinting movement. He even reached his arm over his head to put his shirt on – something that a person who really had dislocated their shoulder would probably be unable to do without re-dislocating it. Read about the “apprehension test.”

I told the coach that I could look at him, but that I didn’t think he had dislocated his shoulder.

I got the stinkeye from several people who muttered under their breaths that “Of course he dislocated his shoulder, he’s done it several times before just like he did now. The BONES were sticking out.”

OK, so he dislocated his shoulder. I’m just a dumb doctor that works in the emergency department.

An hour later, his group gets called for the next round. The kid jumps up and starts running to the holding room.

I went to the coach and told him that if this kid dislocated his shoulder, he should definitely not be wrestling for at least a few weeks and should get cleared by an orthopedist before returning.

One of the parents’ friends gave me another stinkeye and told me to mind my own business.

I just did a facepalm and shook my head.

So little Johnny Floppy Shoulder won his match 13-4. And Mrs. Stinkeye sneered at me as their entourage walked back to the bleachers.

Ever feel like bouncing a Gatorade bottle off of someone’s head?

Thank goodness that wrestling matches don’t have Press Ganey scores.

13 Responses to “Johnny Floppy Shoulder”

  1. DefendUSA says:

    Cheaters eventually get caught. And the “stinkeyes” have to look at themselves in the mirror, too!

  2. tracy says:

    i truly admire your restraint, Dr. Whitecoat! :)

  3. Steve says:

    Ah yes…the classic “we want to curbside you for your medical opinion until it disagrees with our untrained observations”…all the risk of malpractice without any of the pay!

    Kudos for your restraint…

  4. harplady says:

    Sounds like this kid has Ehlers Danlos or Marfans Syndrome. I can dislocate my shoulder and hip several times a day and go on with my day as though nothing happened. Oh, how I wish more doctors would learn about this disorder, so many of us are misdiagnosed and go for years getting undertreated or never diagnosed at all.

    • Stacey says:

      THANK YOU! I have EDS as well and it was the first thing I though of. I dislocate many joints and just put them back in and go on as if nothing happened. Yes there is pain when it happens and goes back in, but if you are used to it it doesnt hurt for long. However, I would have to question a parent letting their child who repeatedly dislocates their shoulder wrestling, continuing to allow their child to wrestle. If its a true dislocation (even subluxation) and he has a connective tissue issue, I dont even want to think of the damage he has done and his pain level in future years!

      I also wish more dr’s would learn about it. I have put off going to the ER for a week and a half after I dislocated my knee because I don’t want to have to go through the process of explaining EDS and having the dr’s look at me like I am crazy that I put it back in myself and am partially weight-bearing. Waited until my Rheumy was back in office!

      • JustADoc says:

        I really am at a loss to explain ER doctors not knowing about Ehler-Danlos or Marfan. Marfan in particular since it is a serious risk for aortic pathology that would appear in the ER.

        Of course there is also nothing in this article to suggest that whitecoat doesn’t know about those diseases. He merely said that one who dislocates their shoulder should probably be evaluated by an orthopedist.

        If the family KNEW he had Ehlers-Danlos or Marfan and withheld that info from a doctor that they asked to evaluate their son for a problem known to be common to patients with that and they wanted it done gratis, then they’re just idiots.

      • Stacey says:

        (Want to reply to ‘JustADoc’ but it won’t let me put it there)

        Don’t get me wrong, I wish more doctorss knew about EDS but in reality I know that the vast majority will never actually see a person that has it. There are forms of EDS that also cause organ ruptures and disections (most forms have some heart involvment varying in severity). I don’t expect my dr’s to know much about it, but I do expect them to do the relevant amount of research about it if I present to them in a manor needing help and hand them some literature to read.

        I also realize nothing in this article leads to us knowing if whitecoat does or does not know about this (these) diseases. Honestly, besides the heart problems, I can completely see why ED dr’s may have more important things on their mind. As this is such a rare and complicated disorder, I (and most other sufferers) tend to take any opportunity to try and educate others about what goes on in our bodies, and this case could be an EDSer who is yet to be diagnosed. I also 100% realize that no ED dr will EVER need to diagnose EDS, for the most part all we need is just one doctor to say ‘Hmmm, you probably don’t have it but maybe you should look into EDS’ and since we are known to be klutzy and have multiple ED visits, this could help someone out.

        I agree, if the parents knew the kid had EDS and asked whitecoat to look at his shoulder but failed to mention the EDS, then I don’t know if those parents really actually understand the severity of this disorder. However if they had known it I am sure he wouldnt have gotten the ‘stinkeye’ and instead got a (probably rude) remark that the poor kid has EDS.

        PS. I am so happy that you know what EDS is :)

    • WhiteCoat says:

      I am well-aware of EDS and preumptively diagnosed a case in a young lady with mitral valve prolapse and chest pain a year or so ago when she found that she had no problem touching her thumb to her radius.
      I considered nicknaming the kid in the post “Johnny Danlos” but thought that not many non-medical people would understand it and that someone who actually had EDS might take offense at me doing so.
      And, for the record, this kid did not have EDS. More along the lines of Jimmy Peanut’s comment below in my humble, but (according to certain parents of members on my son’s wrestling team) uninformed, opinion.

  5. Anonymous says:

    You let your son wrestle without concern for herpes gladiatorum?

    • WhiteCoat says:

      Yep. And I let him go to school during cold and flu season, too.
      They wash down the mats, no one can wrestle without passing a “skin check” and he showers when he gets home.
      If he gets infected, I guess that’s the price of him having fun.

  6. Jimmy Peanut says:

    I wrestled from elementary school into college and I can tell you that the majority of shoulder injuries in wrestling are faked. These “dislocations” usually happen when the wrestler is on his back about to be pinned. Some wrestlers do have very flexible shoulders, but the good wrestlers like this know what they can do and can milk it to make it appear that they’re injured when they’re really fine. We had a guy like that on my college team. Fortunately, most of the guys like that get labeled as fakers or whiners by the time they get into high-school and college competition and the referees don’t have much sympathy for their complaints.

  7. SeaSpray says:

    Yes – about the bottle. :)

  8. LooseJoints says:

    I found this story and the comments interesting from two perspectives.

    One, for some reason I had very loose joints as a child and teen. I would lay in bed and purposely pop my shoulder out of place. Then I would take the other hand and pop it back. I could do this with either one.

    I could also pop my hips out of place.

    Both of these activities disturbed my mother greatly and I learned not to do it around her! It was uncomfortable but really didn’t hurt.

    Fast forward 20 years. My 15 year old son dislocates his shoulder playing basketball. We went to ortho. Yep, it had been dislocated. In a sling for several weeks. PT followed.

    It is now what we call his “trick shoulder”. It periodically pops out if he is at an odd angle with stress on the joint. It is very painful to observe him. He HAS to have help to get it back in. He gets pale, sweaty, truly exhibiting pain.

    My experiences were NOTHING like his.

    I think you were probably right about Johnny. I am positive if he were like my “Johnny” he wouldn’t have wrestled again.

    Probably too long a comment but really just saying, “Johnny knew what he was doing IF it slipped at all.”

    BTW, my favorite part about my son’s dislocation was the coach and principal telling me they “used to just pop ‘em right back in.” The ortho really wasn’t keen on that idea!

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