Avoiding Shoulder Injuries: The Science of a Safer Sport

On a mission

A Yale Medicine physician's quest to prevent lacrosse injuries started with an injury to his own son.

For Theodore A. Blaine, MD, shielding lacrosse players from shoulder injuries is a personal mission.

Luke Blaine’s Greenwich High School lacrosse team was beating Stamford High School by a wide margin when a Stamford defender hit the 15-year-old freshman midfielder hard and drove his shoulder into the ground.

“He was wearing shoulder pads, but they didn’t protect him from injury,” Luke’s father, Theodore A. Blaine, MD, says.  Luke stumbled off the field in pain, the bone obviously broken. An X-ray in the emergency room confirmed a broken right clavicle bone. “He had to miss the remaining eight weeks of the season, due to his injury,” Dr. Blaine says.

A proud lacrosse dad and former player, Luke’s father is also chair of Yale Medicine’s Department of Orthopaedics & Rehabilitation. Just a few days after his son’s injury, the American Journal of Sports Medicine published an article about lacrosse injuries written by Dr. Blaine and several of his orthopaedic colleagues at Yale Medicine. Produced months earlier, it questioned whether the protective shoulder pads lacrosse players wear provide much protection.

“It felt ironic to get this call and learn that my son broke his clavicle and had this shoulder injury that was probably the result of wearing a not-great shoulder pad,” Dr. Blaine says. “But it’s the reason I’d wanted to look into this area.”

Shoulder injuries are painful and debilitating, and they can affect the careers of young athletes. The American Journal of Sports Medicine article reported that 41.9 percent of shoulder injuries require 10 or more days of rest and recuperation. Many players, like Luke, miss entire seasons. That’s bad enough, but those individuals also are likely to face additional suffering years down the road.

Many of the adult patients Dr. Blaine sees with shoulder pain had injuries a decade or more ago that resulted in painful shoulder arthritis.

To learn more about the prevention and treatment of sports injuries, click here.

The science of safer sport

As the father of a lacrosse player and a specialist in shoulder surgery, Dr. Blaine brings a unique perspective to the problem. He and his team are performing further research into what happens when lacrosse players hurt their shoulders.

The new Yale Medicine study will perform a biomechanical analysis to measure how much force is required to sustain a clavicle fracture and a significant acromioclavicular joint injury with and without standard lacrosse shoulder pads. The goal is to develop better protective gear.

“There will be room for new designs to become more protective in ways that prevent these injuries,” Dr. Blaine says. The study uses the same research principles that have been applied to the study of concussions, he says. “Scientists looked at the types of impacts and how many impacts are appropriate,” Dr. Blaine says. “We can look at other parts of the body in the same way.”

The health of athletes such as Nick Nelson, another young lacrosse player from Greenwich, hang in the balance. He  suffered a worse break than Luke Blaine's during a practice drill at the Taft School in Watertown, where he is a student. 

He ran directly into a teammate, hit hard with his shoulder and knew immediately that he was in trouble. “I was wearing the standard equipment,” the 17-year-old says, “but it didn’t help.” Although a broken collarbone usually heals cleanly and without surgery, Nelson’s fractured in two places. Also, the broken parts overlapped, requiring a surgical procedure to install a plate and six screws to permanently hold his clavicle in place.

“I’m not sure the injury was worth it, particularly since it happened in a drill, not a game,” Nelson says. But he says that he feels reassured that the outcome will be good, once he heals. “I know that Dr. Blaine would tell me the truth,” Nelson says. “And he says my recovery will be 100 percent.”

Better standards for all sports

Dr. Blaine expects that once the lacrosse shoulder pad study wraps up, it may take up to three years before new and improved protective gear becomes commercially available. It’s possible that manufacturers may be interested in partnering with Yale Medicine’s orthopaedic specialists to develop safer gear. 

He believes there are other sports and parts of the body that would benefit from this line of inquiry, too. “We’re interested in what we can do to reduce the injury rates in any and all sports," he says.