NOT much has gone wrong for the Western Bulldogs this AFL season. As I write this article they are sitting second on the ladder and are one of the favourites for the AFL premiership.
Unfortunately they have lost one of their key midfielders, Josh Dunkley, for the next few months. Dunkley dislocated his shoulder twice in round six.
The Bulldogs medical team and Josh would have faced a difficult decision after that game as to how to manage the injury for the rest of the season.
It is the same dilemma the local sportspeople in our region regularly face after such an injury. Should they have surgery?
Our shoulders are made up of four different joints. The main joint is the ‘glenohumeral joint’. It is the ball and socket joint.
Unlike the hip joint with its deep socket designed for stability, our shoulders socket is small and shallow and designed for increased movement.
Unfortunately one compromise for the extra mobility is the increased risk of dislocating.
When our arm is wrenched backwards or when we fall onto our elbow, our shoulder can dislocate.
When an athlete dislocates their shoulder for the first time (after it has been safely relocated) we usually have good and bad news for them.
The good news is that it is unlikely they will have ongoing pain, weakness or loss of movement for too long.
Most shoulders return to feeling normal within a few weeks.
The bad news is that they might be facing a high likelihood that the shoulder will dislocate again.
Various factors affect the likelihood that the player will go on to dislocate their shoulder again.
Being male increases the risk. Being younger increases the risk. Playing sports that involve provocative positions increase the risk.
If you were unlucky enough to chip off a bit of bone or cartilage during the incident, then that increases the risk.
Surgery to stabilise the shoulder is very effective. All surgery presents certain risks, but research shows it is effective up to 95 per cent of the time in preventing another dislocation.
So the player is faced with two choices. They can rehab the shoulder without surgery, and probably return to their sport quickly, but risk that the shoulder might pop out again (and possibly regularly) affecting their ability to perform.
They can have the surgery that will result in a much reduced likelihood of further dislocations, but involves several months off sport, time off work, more trips to the physio and plenty of medical bills.
Not knowing what specific damage was done to Dunkley’s shoulder during his dislocations, we do not know how difficult this decision was for him and the Bulldog’s medical team. However, I suspect the fact finals were far enough away that they could expect him to be fit and firing by the time they came around probably played a significant factor in going straight for the surgical pathway.
Pat is a director of Echuca Moama Physiotherapy, which has clinics in Moama, Kyabram and Rochester. For an appointment with Pat, call 5480 0860.
