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I'm on a lacrosse team for my high school. I woke up last week with shoulder pain and clicking when I move it. It's the worst when I reach overhead with my stick to catch or serve the ball. How can I tell if it's a serious injury?

Athletes involved in overhead throwing sports often have shoulder problems. These range from tendonitis to rotator cuff tears to dislocations. SLAP injuries (superior-inferior-labral anterior posterior lesions) of the cartilage are especially problematic.

The labrum is a rim of cartilage around part of the shoulder socket. A SLAP injury means the labrum has pulled away from the bone. It can be rated one to four to show how severe the tear is.

Diagnosis of shoulder problems in athletes is best made by an orthopedic surgeon. A history and exam are the first two steps. Special exam tests can be done to help sort out which soft tissues are involved. MRI may be helpful. The only way to know for sure what's wrong is an arthroscopic exam.

The surgeon inserts a thin needle with a tiny TV camera on the end into the joint. The tool can be rotated around to give the surgeon a good look at the joint, ligaments, and other soft tissues. The arthroscopic exam often confirms and gives details of what the MRI shows.

Talk to your coach about your symptoms. The coaching staff may be able to help you identify what's wrong. As with any acute injury, rest and ice are the place to start. If the symptoms don't get better or go away, then a medical referral is advised.

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