The first time he injured his shoulder, Brian, then 16, simply shrugged it off as a “stinger,” heading right back into the huddle for the next play.

“It was a [football] game,” Brian, a former offensive lineman, recalled. “The defensive lineman pulled on my arm and [the shoulder] popped out of its socket.”

Though the ball of Brian’s shoulder did momentarily slip out of its socket in an unconventional direction, resulting in a likely labrum injury ... it then popped back in after Brian fell, absorbing the other player’s momentum.

More confusing than painful, perhaps, these odd injury mechanics would ultimately lead Brian to labrum surgery at Children’s Hospital of Philadelphia (CHOP) under the expert care of Joseph L. Yellin, MD – but only after exhausting all possible non-surgical treatment options.

A complex labrum injury, a simple nonsurgical solution?

Not only did Brian continue to play in that game, but he also continued taking part in football practice after the injury.

He was clearly struggling though, Alba, his mom, remembers: “I said, ‘You should stop. Let's make an appointment and see.’ But he didn’t want to miss a game.”

Brian’s already damaged left labrum would only last a few more weeks though before another injury, known as a subluxation, made it even worse.

“We were in [football] practice, and I was holding one of the practice dummy pads,” Brian said. “And I took a hit and pain shot from my shoulder like throughout my body.”

Looking back, this was the moment Brian finally realized his labrum injury was a potentially serious one.

A thick layer of cartilage tissue, the labrum helps stabilize the shoulder joint, keeping the ball in the socket and attaching to surrounding structures. When it’s torn off the bone – as it was in Brian’s case – the ball of the shoulder can more easily dislocate to various degrees, causing further damage and pain.

There was hope Brian might be able to strengthen his shoulder and resolve the pain and instability through physical therapy alone.

But it would only be a month before Alba and Brian finally decided to call on CHOP, in search of the best treatment for Brian’s unique situation.

Dr. Yellin, Brian work together to plan comprehensive labrum treatment

Dr. Yellin’s assessment included a physical exam. 

One test in particular made clear just how serious Brian’s injury really was.

“That one kind of folded me,” Brian said with a smile, miming the way Dr. Yellin had pushed against him. But, as painful as it was, it also meant “[Dr. Yellin] knew exactly where, how to explain [my] pain.”

After visiting Dr. Yellin, Brian underwent an MRI which confirmed the torn labrum diagnosis.

But that didn’t mean surgery would be scheduled right away.

“For this particular injury, I always make sure patients trial 3-6 months of non-operative management,” Dr. Yellin said. 

For Brian, that meant more physical therapy, more rest; and more time away from sport.

But this is, as Dr. Yellin explained, a key aspect of labrum tear treatment, a chance to give the body time – and therapy – to heal itself.

Dr. Yellin added that while Brian “diligently did physical therapy, things got a bit worse for him, so that's when the shared decision was made to proceed with surgery.”   

Labrum repair and post-op recovery at CHOP

While surgery wasn’t her first choice, Alba says now that it was Dr. Yellin’s willingness to answer all their questions about recovery and Brian’s return to sport that ultimately made them feel “confident” in labrum repair at CHOP.

“[Brian] was ready [for surgery] at the beginning,” Alba said with a laugh, noting that by the time they got to CHOP, Brian was already aiming to get back to normal as quickly as possible.

Procedure planning was complicated by Brian’s allergy to certain medications, which meant he wouldn’t be able to manage post-procedure pain with normal painkillers. Of course, it helped that the family had a history with CHOP, Brian having undergone successful evaluation and treatment for other issues as an infant.

Dr. Yellin worked directly with the anesthesiologist to make sure Brian’s pain was managed well, during the procedure and after.

“I was a little scared,” Brian admitted, but after several months living with an injured and unstable shoulder, he was also “pretty ready.” 

Without surgery, that joint instability would have meant lifelong pain, and could have potentially impacted Brian’s ability to take part in sports.

“I'm a mom, you know,” Alba said. “I was very worried.” But just like the injury couldn’t stop him, Brian and Alba knew surgery and recovery wouldn’t either.

The March following his initial injury, Brian finally underwent left labrum repair at CHOP, performed by Dr. Yellin and CHOP’s orthopedic surgery team.

Taking a shot at college

For Brian, the worst part of recovery might have been the sudden difficulty playing video games, especially as he waited to start physical therapy with little else to occupy him.

He also couldn’t get his Learner’s Permit right away, a slight delay in his driving freedom.

Ultimately though, small prices to pay as far as Brian and Alba are concerned, more certain now than ever that getting a CHOP second opinion was the best thing they could have done.

And about seven months after the procedure, Brian was able to return to practice with his high school track and field team.

Now 18, Brian won’t play football again ... but that’s only because he’s chosen to commit himself fully to shot put and discus instead. 

He plans to spend the summer working in the gym, making steady gains in preparation for joining the track and field team at Ursinus College next fall. 

He’s also planning to major in biology on a pre-veterinary track.

With CHOP and Dr. Yellin continuing to keep a close eye on Brian’s recovery – the family returned this past March for Brian’s two-year check-up – Alba knows Brian’s in the best position, backed by the best, most knowledgeable people.

“I felt confident in CHOP,” Alba said. “When Dr. Yellin explained about the surgery and when I saw Brian look fine – comfortable – talking with Dr. Yellin and everything, that’s when I said, ‘Okay.’”