Jock Doc

A pop in the shoulder, followed by pain, should be examined by orthopedic surgeon

Q. Last week I fell on my left arm and felt a pop in my shoulder. It really hurt and I went to the emergency room. They took X-rays and told me nothing was broken. I was told I had a sprain, given a sling and told if I was not better in a few days to see an orthopedic doctor. It is about 50 percent better and I stopped using the sling. I still cannot move it all the way, and the pain is worse at night. Do you think it will get better by itself or should I see the doctor?

A. When you have an injury, feel a pop, have residual pain and weakness, I believe you should see an orthopedic surgeon. Since your X-rays did not reveal a fracture, the most likely diagnosis is an injury to your rotator cuff tendon or labral cartilage.

The rotator cuff tendon is formed by the four muscles that let you rotate your shoulder as they attach to your shoulder bone. If this is torn in an active person, it may require surgery to fix and prevent the tear from getting larger and more difficult to treat.

The labral cartilage helps to stabilize the shoulder. Depending upon the location of the injury and lifestyle of the patient, repairing it may also require surgery. There are less severe injuries in the shoulder that may respond to physical therapy.

Your physician will examine the shoulder and likely order an MRI scan, which can help diagnose the extent of the injury and come up with the best treatment plan.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send questions to