@Cam Deckett yeah surprisingly he wasn’t being a baby about it. He was in a fair amount of pain but not making a big deal over it. Immediately felt it under his shoulder pads. I’ve seen probably a dozen or so of these in real time in my career. All but one, a distal clavicle buckle fracture, was obvious. Easy referral to our doc. Bing bang boom.

@Cam Deckett second fracture already this season. Three weeks in. Week 0 (scrimmage) was a distal radius that resulted in surgical repair. That one was gnarly!

Good question! 🤔 I probably can come up with a handful. But one I learned maybe the hard way early on is that if you can give a dislocation two good attempts at relocation, especially in smaller joints like in phalanges, and it doesn’t reduce…refer, because it’s probably a fracture and NOT a dislocation. Don’t get overzealous.

Can’t say I’ve seen or heard of this before. Following.

Welcome Ryan! 💪🏼

May be a stupid question @Joel Watts, but did you guys rule out an avulsion fracture of the ischial tubercle? If it’s a high school athlete (or even collegiate really) it’s something you may want to highly consider if it hasn’t been done yet. It could be as simple as an apophysitis at the origin of the hammy that’s causing him the issue. I’m always of the mindset, especially with an adolescent joint, to rule out worst case (fractures, complete disruptions, etc) then that way I know what my next course of treatment will be. Also, unless it’s completely contraindicated for one reason or another, I use diagnostics sooner than later as a psychological “treatment.” Meaning, if you feel it’s mental with the athlete and can’t objectively explain away the pain/malingering component, get the picture of the athletes skeleton and show them there’s nothing structurally wrong. And, you can show the coach that nothing structurally is wrong. I’ve found there’s something magical that happens with an athletes complaint when you can prove to them objectively that “nothing is really wrong.” Then you can start throwing the kitchen sink at them as far as modalities, etc. Hope that makes sense.

@Joel Watts you’re in the HS setting? Is your physician setup more of a network of docs or do you guys technically have “team” docs assigned to each school?