Vladimir Tarasenko has been placed on long-term injured reserve by the St. Louis Blues following shoulder surgery back in September. This was the THIRD surgery in three years on Tarasenko’s left shoulder. The recurring problem, unfortunately, seems to be related to repeated dislocations of the joint. Much like the hip joint, the shoulder is a ball and socket joint. The difference though, is that the shoulder has a larger ball, and a smaller, more shallow socket (think a golf ball on a tee). What that means is that compared to the hip joint, the shoulder has way more range of motion available. However, the trade-off is a joint that is much less stable. The shoulder actually gets most of its stability from muscles surrounding the joint, in particular a group of four muscles called the rotator cuff. Like the hip, the shoulder also has a labrum, a rim of cartilage around the edge of the socket that seals the ball in place. This provides some stability, along with some ligaments (structures that hold bone to bone).
When the shoulder dislocates, the ball is dislodged from the socket. Most commonly, it is forced out when the shoulder is forcefully abducted (moved out to the side) or externally rotated (ball rotated outwards) or some combination of the two movements. The ball usually will come out forwards, or downwards. As the ball comes out, it can cause damage or tearing of the labrum, and in some cases, you can get damage to the bone, as well as an injury to one of the rotator cuff tendons. And, as is the case with Tarasenko, the biggest risk for this type of injury to occur, is a previous shoulder dislocation. You lose some of the structural integrity after that first dislocation, and each time, it tends to happen with less and less force. In certain cases, it can happen just by reaching for something awkwardly!
The surgery to repair this type of injury is arthroscopic. The surgeon uses tiny incisions to insert a light, camera, and tiny instruments to essentially tighten up injured ligaments and tendons, and repair the labrum as needed. After the repair, the shoulder is placed in a sling for around six weeks or so, and they are usually not allowed to rotate the shoulder outwards very much at all for that time frame or longer, to reduce the risk of dislocation. Strengthening usually can’t start until around the 12 week mark, and is pretty light initially. It is a long road to recovery, often taking 5 to 6 months or longer!
Again, hopefully Tarasenko is able to avoid yet another injury to his left shoulder upon his return, but the risk for further dislocation will most likely be elevated throughout his career and beyond.