During summer break, you might expect to find high school students taking it easy. Not Topeka High quarterback Peyton Wheat. His main focus has been getting healthy after suffering a shoulder injury in a game last year.

“When I got tackled, I landed on my shoulder and dislocated it,” he said. “When I stood up, it popped back in and then I went to punt the ball, caught the snap with one hand and then went to the sideline. I started throwing, and the pain was tolerable, so I went back in for a quarter.”

Wheat scrambled during a play and threw the ball 30 yards out of bounds before his shoulder dislocated again. Once he stood up, he immediately went back down to the ground and knew something was wrong.

Wheat was able to finish out the season for Topeka High, but he was still having problems, and family friends who worked in athletic training were fairly certain something was wrong with the labrum in his throwing shoulder. So he went to OrthoKansas for a diagnosis.

More than meets the eye

Dr. Douglass Stull is an orthopedic surgeon at OrthoKansas specializing in shoulder care. He treats a variety of conditions for athletes with throwing injuries, including athletes from the University of Kansas. When Wheat came in for care, Stull was prepared.

“Peyton presented with pain, shoulder instability and the inability to throw the football effectively,” Stull said. “He also displayed a lack of shoulder proprioception which means that he had the feeling that his shoulder was slipping out of place. It’s a feeling that can be subtle, but it’s designed to protect you.”

Stull ordered an MRI to determine the extent of the injury to Wheat’s shoulder. When the images came back, it was just what he’d anticipated — a labral tear to the back of the shoulder.

“Any labral injury to a throwing athlete is career-threatening,” Stull said. “It’s not a life-altering injury, but without intervention, Peyton wouldn’t be able to play quarterback at a high level. He would have to have moved to another position that didn’t involve throwing all the time.”

Based on the injury, Stull recommended surgery.

Wheat was wheeled into the operating room just a few days before Christmas. Once the surgery began, though, the team encountered something unexpected — an injury called a capsule tear that the MRI hadn’t picked up.

“We only saw one injury on the imaging, so to find a ligamentous tear together with a labral tear was a surprise and not very common. Fortunately, it was one that we could also address then and there,” Stull said.

Wheat didn’t know anything about the second injury until after the surgery.

“I didn’t really process that I’d also had a capsule tear until a day or two after surgery,” he said. “My mentality didn’t change much, because I trusted my team and I knew I was going to get back to where I needed to be successful on the field.”

The road through rehab

Before undergoing surgery, Wheat wanted to be as prepared as possible. That meant working with a physical therapist — Justin Rohrberg with LMH Health Therapy Services — for a few weeks prior to his surgery.

“When a patient comes to us for pre-op physical therapy, it allows us to establish their baselines using the advanced technology we have,” Rohrberg said. “We used our isokinetic testing machine — one of only a few available in Kansas — to evaluate the movement, strength and stability in both of Peyton’s arms and then track his progress throughout rehab.”

Wheat hopped back into therapy the week after his surgery. At first, his therapy was the same type of exercises that anyone who’d had surgery would be doing, whether they were an athlete or not. These were lower-impact exercises designed to improve his range of motion. However, as Wheat continued to progress, Rohrberg tailored the sessions to incorporate more of what Wheat would experience as a throwing athlete.

“We worked on lots of overhead strength and stability exercises for the shoulder joint and scapula,” Rohrberg said. “This included intertwining lower extremity work, because that’s where much of the power for the throwing motion comes from. I encouraged Peyton to keep up his leg strength as we continued to work on his shoulder.”

Rohrberg said the therapy also included “tasks that simulated the experience that Peyton would experience during a football game, such as rolling on the ground and pushing up.”

As rehab progressed, Rohrberg continued to monitor Wheat’s progress using the isokinetic machine as well as the team’s newest piece of technology, force plates from VALD Performance. Wheat underwent an athletic shoulder test using the plates. This meant that he would lie flat on the ground, place his arm on the plate and push through his range of motion. He’d then repeat the test using the other arm.

“Being able to use the force plates gave us the opportunity to collect more data, letting us know more about Peyton’s strength. Comparing that to normative data from uninjured people in the same age group helped us to determine where he was at in recovery,” Rohrberg said.

Mental recovery

Overcoming a physical injury is only part of the rehab process. Fear can play a big part for athletes of all ages and abilities seeking to return to their sport.

“Confidence is a huge thing to get back following surgery and rehab,” Stull said. “It’s normal to have some anxiety. Until you take that first hit, you don’t know how you’re going to perform.”

Wheat continues to work on strengthening his external rotation through exercises and stretches. He’s also working with a throwing coach each week.

“My mechanics were a mess, and mentally, I didn’t trust my shoulder. The mental aspect of an injury can be very hard,” Wheat said. But he said his throwing coach and physical therapy team had helped him out a lot, and he’s confident that he’ll be ready for the upcoming football season.

At Wheat’s first game on Sept. 3 against Maize High, Rohrberg and other members of the therapy team plan to be there to cheer him on.

“I knew from the start that OrthoKansas and LMH Health were the right place for this journey. I trusted Dr. Stull, Justin and the rest of the staff. They never put doubt in my mind that I wasn’t going to be back on the field,” Wheat said. “Without them, I wouldn’t be close to where I am physically or mentally.”

— Autumn Bishop is the marketing manager and content strategist at LMH Health, which is a major sponsor of the Journal-World’s Health section.