Minnesota Golden Gophers head coach Richard Pitino announced Saturday night that sophomore guard Amir Coffey will be sidelined for the remainder of the season and will undergo surgery to address a right shoulder injury that occurred during the Jan. 3 win over Illinois and was aggravated on Jan. 23 in a loss to Northwestern.
At the time of the injury, Coffey’s father, Gophers legend Richard Coffey, told the St. Paul Pioneer Press that his son had suffered a humeral avulsion of the glenohumeral ligament.
The former Minnesota Mr. Basketball had missed 10 games this season due to the injury.
Humeral avulsions of the glenohumeral ligament, or HAGL lesions are rare injuries, occurring in a minuscule 2-9 percent of all shoulder injuries that result in instability. This type of injury involves the glenohumeral ligament — most often the anterior (front) portion of the inferior (bottom) aspect — being torn away from the humerus and bringing along with it a chunk of bone.
Beyond pain and discomfort, this injury results in instability of the shoulder, particularly with combined abduction (lifting the arm straight out to the side) or flexion (lifting the arm straight to the front) beyond 90 degrees and external rotation, which is the prototypical shooting position.
Magnetic resonance imaging (MRI), magnetic resonance arthrogram (MRA; a dye is injected into the joint to provide contrast) and radiographic imaging (x-ray images) are typically utilized to diagnose a HAGL lesion.
HAGL lesions can be treated both conservatively (i.e. physical rehab) and surgically, with size and location of the lesion being the greatest determinants for which path is ultimately chosen. Although more studies need to be conducted, the current research would seem to indicate that surgical intervention is more likely to decrease the recurrence of instability episodes, including subluxation.
There are two surgical techniques that are utilized to address HAGL lesions: open repair and arthroscopic repair.
Open repair involves “opening” the shoulder with a large incision whereas the arthroscopic procedure is much less invasive, involving a small incision and use of an arthroscope — a tube-like surgical tool that comes equipped with a camera.
Both procedures share the common goal of repairing the glenohumeral ligament and reattaching it to the humerus. The rehabilitation protocols for the open and arthroscopic procedures and the eventual return to play differ slightly.
With the arthroscopic technique, partial passive range of motion exercises are typically initiated immediately after surgery and are progressed to full passive range of motion over the course of six weeks. After six weeks have passed, active range of motion exercises are begun and are progressed to resistance exercises over the coming weeks and months.
Players typically return to full activity in approximately three months.
With the open technique, partial passive range of motion is even more limited for the first four weeks but is progressed to full passive range of motion by the same six-week timeline.
After six weeks, resistance exercises are begun with the player returning to full activity in approximately four months.
The Gophers originally had Coffey attempt to rehab his shoulder through conservative means, but ultimately determined that surgery was needed to address his symptoms. 1500ESPN‘s and KSTP‘s Darren Wolfson reported that Coffey is expected to be out 5-6 months, slightly longer — but still within a normal range — than the timelines provided above.
This type of injury shouldn’t have many, if any, lingering effects if surgery is successful and it is rehabbed appropriately. Chalk it up as another bump in the road in the young Gophers’ promising career.
