Making Sense of Joakim Noah’s Shoulder Injury

• Post By: Jeff Stotts
• Date: January 16, 2016
• Category: NBA, Understanding...

Bulls center Joakim Noah sprinted off the court Friday in clear agony after suffering his second shoulder injury of the season. As the game progressed confusion about the specifics of the injury had many people scratching their heads as they attempted to determine what it could mean for the Bulls and their energetic center’s future with the franchise. Shortly after leaving the court it was reported that Noah has separated his left shoulder and would not be available for return.

Bulls PR says Noah separated his left shoulder and he won’t return. It’s the same shoulder he separated on Dec. 21.

— K.C. Johnson (@KCJHoop) January 16, 2016

However just minutes later the injury classification was amended and a dislocated shoulder was reported.

Bulls PR now says left shoulder dislocation for Noah. Regardless, same shoulder and bad. Last time they waited 2 weeks to rule out surgery

— K.C. Johnson (@KCJHoop) January 16, 2016

The confusion would continue, as the classification of the injury would vacillate between a dislocation and a separation until a dislocation would be the agreed upon final diagnosis.

Bulls PR now says left shoulder dislocation for Noah. Regardless, same shoulder and bad. Last time they waited 2 weeks to rule out surgery

— K.C. Johnson (@KCJHoop) January 16, 2016

While this wording may seem inconsequential, the difference between a separated shoulder and dislocated shoulder is significant. The shoulder is comprised of multiple joints and articulations. It starts where the clavicle (collarbone) connects to the sternum at the sternoclavicular (SC) joint. The collarbone than extends away from the midline of the body and attaches to the scapula (shoulder blade) to form the acromioclavicular (AC) joint. The AC joint acts like a strut, allowing the arm to be raised overhead. When the ligaments that stabilize this area are injured, it is referred to as a shoulder separation. AC sprains have a very specific grading scale that depends on the severity of the damage to the ligaments and surrounding structures. In recent seasons, NBA players including Kyrie Irving, Chris Paul, and Anthony Davis have missed time with AC joint sprains.

The joint most people associate with the shoulder is the ball-and-socket joint of the shoulder, medically referred to as the glenohumeral joint. The glenohumeral joint is formed from the proximal end of the humerus and the glenoid of the shoulder blade.

Together these structures loosely resemble a golf ball sitting on a tee. The head of the humerus acts as the golf ball while the glenoid serves as the tee. The ball (head of the humerus) can freely pivot on the tee (glenoid) allowing for a large degree of motion. To reinforce the area and insure the ball remains on the tee, a cartilage ring known as the labrum stabilizes the glenohumeral joint. Additional musculature, connective tissue, and soft tissue also provide additional stability to the area.

Unfortunately this alignment can be disrupted in varying degrees following repetitive force or more commonly direct trauma. If the displacement is minor and the shoulder joint slips out but naturally returns to its normal position, the injury is considered a subluxation or partial dislocation. A total dislocation occurs when the displacement of the joint is complete. Following an injury of this severity, the joint must often be realigned by medical personnel and is considered a much more serious injury.

Noah’s previous injury may have played in a role in his latest ailment. Noah suffered what was described as left shoulder sprain earlier this season and would miss nine games recovering. However Noah admitted he felt the shoulder come out of place and, in an interview following a MRI, the injury was described as a “slight tear.” Though the location of the tear was never revealed, damage to either a ligament or the labrum would result in an instability and make it easier for a true dislocation to occur.

As previously detailed following Kevin Love’s shoulder injury, the return to play time following a shoulder dislocation is often dependent on the severity of damage accrued by the neighboring structures, particularly the labrum. A significant labrum tear, like the one suffered by Love, would be a devastating injury for Noah as surgery could be a necessary option. Love spent months recovering from his surgery though the timing of the injury makes it a difficult comparison. The InStreetClothes.com injury database previously uncovered 18 in-season injuries classified as complete dislocations with varying recovery times.

Given Noah’s previous injury and the state of the locker room following the team’s loss to Dallas, it appears the Bulls are preparing to be without their “emotional leader” for a prolonged period of time. The impending MRI will provide a final diagnosis and help shape the course of treatment and Noah’s future with the Bulls.

UPDATE: The Bulls have announced Noah will undergo surgery and be out four-to-six months.