Shoulder Surgery and Rehabilitation Help Avery Return to the Mound

For 17-year-old Avery Guck, baseball has always been more than just a sport. The standout pitcher hopes to play college, making every season an important step toward that goal. But after a shoulder injury during football season, those plans were suddenly put on hold.

Instead of spending this spring on the pitching mound, Avery spent months focused on surgery, rehabilitation, and patiently rebuilding the strength needed to safely return to competition.

A Setback That Threatened His Season

The injury happened during football practice when Avery was blocking another player and his arm twisted awkwardly.

“It got dislocated,” Avery said. “It was a subluxation.”

Unlike a complete shoulder dislocation, subluxation occurs when the shoulder partially slips out of the joint before moving back into place. At first, Avery tried to ignore the injury and continued playing.

“It took me maybe about a month to go talk to the trainer,” he said. “It happened two or three more times before I finally got it checked out.”

The shoulder continued to feel unstable throughout the remainder of the football season. X-rays did not reveal the problem, so an MRI was ordered after the season ended. Once the injury was identified, Avery began physical therapy to see if that would resolve the problem.

“As with any first-time shoulder instability event, we really try to treat these injuries without surgery,” Perham Health orthopedic surgeon Dr. Kyle Muckenhirn explained. “The first step is physical therapy focused on strengthening the rotator cuff and the muscles that stabilize the shoulder.”

The plank cross-over weight drag exercise works on core and scapular stabilizers.

Avery worked with physical therapist Pete Anderson to restore strength, mobility and function while carefully monitoring pain.

“We were able to fully alleviate his pain at rest and with day-to-day activities, as well as regain his full strength and mobility,” Pete explained. “However, when he tried high-velocity activity such as throwing and pitching, that kept irritating his shoulder, and it was a point that we just were not able to get past.”

When Rehabilitation Wasn’t Enough

“He’d lost his velocity. He had pain with throwing,” Dr. Muckenhirn said. “At that point it became, ‘Let’s get you back for future sports,’ so we went ahead and repaired his labrum.”

Learning he needed surgery was disappointing.

“It was pretty tough,” Avery said. “Knowing that I would miss baseball and that it would set me back.”

His mother, Nicki, appreciated how thoroughly Dr. Muckenhirn prepared them for what was ahead.

“He’s been super awesome,” she said. “He explained everything and told us it was going to be a process with surgery and rehabilitation.”

During the surgery, Dr. Muckenhirn repaired Avery’s torn labrum using three small anchors to reattach the damaged tissue to the bone.

“The labrum forms a ring around the shoulder joint and deepens the socket to provide stability,” Dr. Muckenhirn explained. “In young athletes, even subtle instability doesn’t function well because they place such high demands on the shoulder.”

The surgery lasted about an hour and a half, and Avery returned home the same day.

Recovery went more smoothly than the family expected.

“We were expecting maybe a little more pain,” Nicki said. “But he had absolutely no pain, no swelling.”

The Road Back to the Mound

For the first six weeks, Avery’s shoulder remained in a sling while the repaired tissue healed. Physical therapy began three weeks after surgery with gentle movement, then gradually progressed to strengthening exercises.

The weighted ball exercise works on concentric/eccentric control, dynamic stability.

Pete guided Avery through every phase of physical therapy.

“Initially, we focused on keeping his shoulder loose with passive range of motion,” Pete said. “Then we worked on strengthening in a limited range of motion to build stability and regain motor control before progressing to full mobility and strength.”

Avery attended therapy twice a week for the first several months. Throughout the process, Pete said Avery’s attitude made a difference.

“Avery is a great kid who is really easy to work with and was always ready to work,” Pete said. “He has a lot of passion for sports and was really motivated to get back out there.”

Twelve weeks after surgery, Avery transitioned to the Sanford Sports Complex in Fargo for specialized physical therapy designed specifically for baseball players.

“I recommended that Avery switch to the Sanford sports therapy in Fargo to work on return to throwing. They’re very specialized with throwing, and also have state-of-the-art equipment and cameras that can really help in the analysis of Avery’s technique. The focus was on throwing and pitching at high velocities while maintaining good shoulder stability and control. I wanted him to have the best opportunity to return to his prior level of function as a very successful pitcher,” Pete said.

Successful Sports Medicine

Today, Avery reports no pain and no setbacks.

Using the body blade works agonist/antagonist for explosive movements and shoulder stability.

“I know eventually I’ll get back,” he said. “If I keep working hard enough, I’ll get back to where I was.”

Although missing an entire baseball season was difficult, he stayed involved with his team by attending practices and games.

“They did a great job of including me and making me feel like I was still part of the team,” he said.

His focus now is continuing his throwing program and preparing for next season.

For Dr. Muckenhirn, that’s exactly what successful sports medicine is about.

“The goal is to get athletes back to doing the sports and activities they enjoy,” he said. “There’s nothing better than seeing someone return at 100 percent.”

For Avery, that means he’ll be back playing football this fall and come spring, he’ll be back on the mound working towards his college baseball playing dream.