It’s difficult for John Gannon to describe what his arm felt like while blocking an opponent during a football kickoff in the fall of 2018. That’s because his arm was bent and pushed in unnatural angles that can only be described as “pretzel-like”, causing his shoulder to pop out of its socket. John, a 17-year-old three-sport varsity athlete (football, baseball, swimming) and Neptune High School junior had suffered a posterior labral tear of his shoulder. It wasn’t the first time he had hurt a shoulder; however this shoulder injury was enough to send him to Dr. Patrick Buckley at University Orthopaedic Associates.
What Is a Labral Tear?The shoulder joint is comprised of the humerus (upper arm bone, the head of which acts as a ball) and the glenoid (socket). The socket of the shoulder is shallow and can be unstable. The labrum is a structure that acts like a bumper, to hold the head of the humerus centered on the glenoid to allow for movement of the arm. With trauma to the shoulder joint, especially when the shoulder dislocates, the thick labral tissue is prone to tearing. These tears are common in collision sports, such as football, but also affect an overhead athlete like John who relies on shoulder motion and stability for baseball and swimming.
Labral Tear Treatment OptionsIn the course of John’s appointment, Dr. Buckley explained his options to both John and his mother. Relates John, “He told me I could try to play through it. I could go to physical therapy (which I had already been through) or I could get surgery right away. Even though I could have played through it, Dr. Buckley explained the risks of doing that.” John felt those risks—chipped bones, continued pain and missed time, and further tearing of the labrum causing greater instability and weakness—weren’t worth it. “It would have been all downhill,” John decided. “It’s cartilage. It could get worse, not better.” Dr. Buckley made John feel that by attempting the play through his injury, “the consequences outweighed the benefits,” he said. John realized that this type of injury does not completely heal on its own, and often requires surgery. Even more important, he had hopes of being ready for baseball season, his main sport, which he also intends to play in college. Using arthroscopy, Dr. Buckley performed a posterior labral repair and a posterior capsulorrhaphy (repair of the joint capsule) to address John’s shoulder pain and instability. Dr. Buckley performed this surgery in a minimally invasive way through three, one-inch incisions around the shoulder. The surgery, says John, was done in “perfect timing.” Eyeing his baseball season, he explains, “I felt comfortable with the four-month timeline for recovery that Dr. Buckley gave me. I healed pretty quickly.” Like all such surgery, John’s recovery included rehabilitation. That’s when it really helped to be an athlete. “I knew what to expect in rehabilitation, and the work I had to do to get back onto the field,” says John. “Being an athlete helps 100 percent. I understand the hard work and the dedication it takes to get better.”
A Satisfied CustomerJohn knows he found the right surgeon. “When Dr. Buckley explained things, he was super confident,” says John. “That made me confident in him. He was thorough, and I was comfortable with him. He’s a good guy.” Beth Gannon, John’s mother and the parent of four athletic children, is an expert at finding the right medical professional for her kids. “Parents talk a lot on the sidelines of games about which doctors to see,” says Beth. “I tend to sit back, listen, and take it all in. It’s a difficult situation, since everyone sees these doctors at a traumatic point.” Her analysis: “Dr. Buckley explained how the body and the healing process works, and every treatment option for John’s injury. It was important to him that John understood. “He is so personable and cared about my son from the get-go. When Dr. Buckley spoke, he wasn’t looking at me. He spoke directly to John. That was a huge plus. He was never condescending and always supportive. I knew right away John felt comfortable with him. He was also sensitive to the fact that John wanted to get back onto the field. He helped him to make an informed decision.” In fact, so enthusiastic is Beth Gannon with Dr. Buckley’s care that she recently took John’s twin brother Ryan, also a multi-sport athlete, to Dr. Buckley for a lacrosse injury.
Back Behind the PlateIt’s baseball season, and John Gannon is back behind the plate playing catcher. “I can work out regularly, swing a bat and catch a ball,” he happily reports. As of this writing, the Neptune High School catcher and clean-up batter is having a stand-out season, batting .470 with five homers. He was the Player of the Week in week three for the Shore Conference. Concludes John, “I feel like a have a new shoulder. It’s stable; it’s strong. I’m good to go.” If you have experienced a labral tear of your shoulder, request an appointment with University Orthopaedic Associates. Our shoulder experts will diagnose your injury and help you pick the most effective treatment option to return you to your goals.
Sometimes, a job is just a job. But other times, there are risks that catch us by surprise. That was the case for 53-year-old Spotswood, New Jersey resident Bijen Patel, whose career as a restaurant manager led him down a path to physical disability. That’s because one of his restaurant roles entailed lifting boxes and buckets, some as heavy as 50 pounds or more. And how long did he perform this gym-worthy task? “Over 25 years,” he reports. “Too many years.” His current restaurant stint that began in August 2017 requires a 60-hour week. That all adds up to a lot of lifting. What’s more, he admits that in hindsight, he also wasn’t lifting with proper technique. “The pain built up over time and age; it all catches up to you,” he says.
Finding a Solution to a Common ProblemThe trouble began in early 2018. Slowly and intermittently at first, he began to experience arm pain radiating down to his right hand. He went to his family doctor in January, who gave him a cortisone shot to ease the pain. That worked, until it didn’t. The cortisone wore off and the pain returned. Patel went back to his doctor in April, who told him that continuing pain could not be solved by more cortisone injections. The doctor told Patel that he should see an orthopedist and recommended University Orthopaedic Associates (UOA). In July Patel was paired with Dr. Christopher Doumas, a hand and upper extremity specialist at UOA. Relates Patel, “As soon as I told him about the pain, he performed an ultrasound to see if there was damage to the [tendons] of my right arm.” Dr. Doumas pointed out a couple of areas of tendon disease evident from the ultrasound, coming from Patel’s elbow. This was confirmation of a condition called lateral epicondylitis, also known as tennis elbow. Although Patel felt the pain extending into his hand, lateral epicondylitis is the most common cause of elbow pain, which especially affects those age 40 to 60. It is caused by repetitive use of the wrist extensor muscles and tendons. In addition to tennis and other similar sports or activities, tennis elbow is a common malady among workers such as plumbers or painters and those like Patel who often lift heavy objects. It was evident to Dr. Doumas from the ultrasound and failure of conservative treatment that a small procedure was the next step. “This is the best course of action that can help you heal, and can prevent further damage to the tendons,” Dr. Doumas told Patel. Surgery is not a recommendation Dr. Doumas makes lightly. Careful and conservative treatment is the basis of his personal experience and philosophy. But in Patel’s case, the procedure was clearly indicated. In addition to other methods of tennis elbow treatment, Dr. Doumas is also an expert in Tenex Health TX, a minimally invasive outpatient surgery that precisely targets and removes damaged tissue. This surgery has been shown in a number of clinical studies to decrease pain and improve overall functionality. It is also much less invasive with less risk involved than typical open procedures and is performed under local anesthesia so the patient is awake without any of the risks or ill effects of anesthesia On November 14th, Patel underwent outpatient surgery. “It was easier than I thought,” he says of Tenex recovery. “I didn’t feel anything other than a little pain on the second night.” He took some Advil that night but no other pain medication.
The Road to RecoveryPatel was instructed to keep his arm in a sling and remained on disability for three weeks. “I missed going to work,” he says, “but I had no choice. I couldn’t do my job since I mostly have to use my right hand.” He went back to work on December 8, and when he explained to his coworkers that he couldn’t initially lift anything, they all pitched in and helped him. Patel began light lifting by the middle of January and his recovery continues. Overall, “everything is fine,” he reports. To minimize the risk of getting a recurrence, Patel gets by with a little help from his friends. “I used to pick up merchandise, load and unload,” says Patel. “Now, my coworkers do it for me. ‘You stay in the restaurant; we’ll do everything else,’ they tell me.” Of his care from Dr. Doumas he says, “I’m happy. I found the right doctor. Dr. Doumas is a very pleasant person. By my second appointment, I felt like I had known him for a long time.” Of UOA and his treatment he feels that, “everyone was very professional and courteous.”
Longing for His GameOnly one hurdle remains. As he explains, “The bad thing is I can’t golf,” says Patel. He’s enjoyed the sport since 2004 but has missed for the past two years. “It is hard, believe me,” he says. But with care from Dr. Doumas and UOA, it’s back to the links for Bijen Patel. “I’m definitely getting back to golf,” he promises.
I had my shoulder surgery October 7th. with Dr. Coyle, and I would like to say thanks for a tremendous job before and after. Not forgetting all those I interacted with from the time started the process at the Group's office, X-ray, MRI, and Surgery scheduling, I was met with nothing less than proficiency & efficiency. On the day of the surgery, at the PreOp, Janice and Jennifer, and at PACU Susan, as well as Joan Grady, and to all the others that I didn't catch their names, you really are the utmost of caring & competence. Thank you all.May God bless you all.
“I am forever indebted to Dr. Doumas. I think he is an amazing doctor. He saved Ariana’s opportunity to compete. He will now be on board our team as she grows in the sport.” Read Ariana's Story
University Orthopaedic Associates of NJ has outstanding doctors, each with a specific area of specialty. While this may make you think that they will not know you personally, especially if you have injured more than one body area. The opposite is true. By your second visit you will have a repore that includes kindness, compassion, and the ability to put you at ease. They will answer any question including the day of your surgery. But don't think that because they're all surgeons that surgery is their first option. Physical therapy and pain management were just two of the modalities used before we decided after 2 - 4 years of treatment before surgery HAD to be scheduled. I have been going to University Orthopaedic Associates since about 1999. My husband also needed spinal surgery and had the same positive experience with Dr. Chiappetta. When my shoulder and upper arm were injured, Dr. Leddy's response was physical therapy - not surgery. I cannot say enough tremendous things about UOA. They all provide the highest quality of care. No egos here - just sensational doctors creating an improved quality of life for all they touch.
I have seen over the past years, Dr. Doumas for my elbow injury, and Dr. Chiappetta for back and neck. I am now seeing Dr. Swan for my knee. All are excellent and I highly recommend this group of doctors.
Dr. Swan takes time explaining all procedures and is attentive to all of my problems. I am not an "easy" patient to deal with, but he is very understanding and puts my mind at ease. With Dr. Swan, I feel three is no need for another opinion. I have total confidence in his ability .
Dr. Bechler repaired my right shoulder in 2003 and Dr. Monica repaired my left shoulder in March 2015. Dr. Monica got me healed up and ready to continue my weekend warrior fun of mud races and softball. I was playing ball again in mid-July and did my first mud run (the easy one) the Rugged Maniac (a 5k run with 18 obstacles) in late July. I then prepared for the Tough Mudder that I completed last weekend which was a 10 mile run with 22 obstacles).
2016 I will find my next tough mudder in October but also try my first Spartan Beast which is 12-14 miles, 30-35 obstacles (I may need a doctors note from you so my wife will let me do it)- thanks Dr. Monica !!
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