OrthoVirginia Blog

Zack – Shoulder Instability/Return to Sport

Keith Lawhorn, MD
Austin G Johns CSCS CES HC

Just a few years ago, Zack’s shoulder was so unstable it would dislocate anytime he moved his arm a certain way. The 21-year-old worried constantly that it would pop out. Fed up, and unable to play the pick-up hockey he loves, Zack consulted Keith Lawhorn, MD, an OrthoVirginia surgeon with expertise in treating complex shoulder instability. 

The problem stemmed from shoulder reconstruction performed when Zack was 15, which left the joint vulnerable to dislocation with any flexion or abduction that exceeded 60 degrees, regardless of activity. He was unhappy and wanted a stable shoulder.

 To address these problems, Dr. Lawhorn performed a debridement, repair and stabilization of the non-union site, as well as a Latarjet procedure. This technique is used when there is significant bone loss in the glenoid (the shallow socket in the shoulder blade) from repeat dislocations. The surgeon transfers the coracoid – a bony structure from the front of the shoulder blade – and its tendinous attachments to the front of the shoulder socket. Latarjet is very successful for restoring stability to the shoulder joint in patients such as Zack who have multiple issues that require a multifaceted approach.

After successful surgery and physical therapy, Zack had the structural integrity to return to hockey, but lacked the strength and conditioning to do so. He enrolled in OrthoVirginia’s Return to Sport program to regain the performance needed to perform athletically.

Under the guidance of Return to Sport director Austin G Johns CSCS CES HC, he began a 12-week program of careful, progressive exercise, flexibility training and sport-specific muscle re-education. When he began the program, he couldn’t perform a pushup without pain and was unsure he’d ever play hockey again. By the end of training, Zack was back on the ice and able to take impact from his teammates.

Hockey isn’t the only thing challenging Zack these days. With a degree in automotive technology from NOVA, he routinely does the heavy lifting to repair diesel trucks and other big rigs at his job. “Every day at work, I pick up tires that weigh more than 50 pounds, so it’s good to have my strength back,” he says. “There’s no instability in my shoulder at all. I don’t even think about it anymore.”