If you play sports and suffer an injury that needs surgery, do you need to have surgery right away? Can you play the rest of the season and have surgery after the season?

Tony in Charleston, SC asks:

My son dropped a barbell on his nose about 5 months ago. He needs surgery to correct cartilage damage, but doctors have said it isn’t a hurry. However, he does have trouble breathing out of one side of his nose, he whistles through his nose when he sleeps, he and seems to be uncomfortable. He wants to wait until December for surgery because he’s in the middle of fall baseball season. What’s your advise … now or later?

I won’t pretend that I am an expert on injuries to the nose, as there are Ear, Nose, and Throat specialists better to address the specifics of that type of injury. Having said that, I think there are some general principles to keep in mind whether to have surgery now or undergo surgery after the season.

Baseball, more than just about any other youth sport except maybe soccer, is one played throughout the year. If I see an injured athlete in one of these sports and feel that he or she needs time to rest or recover, the discussion often turns to when an athlete can take time off. I often hear statements such as, “She just needs to get through a tournament in two weeks and then she can rest.” Or a father will say, “This season doesn’t matter. He should have surgery now to be ready for his high school season.”

Occasionally surgery has to be performed soon after the injury. While some sports medicine injuries can be treated electively (see my Ask Dr. Geier Friday column about shoulder dislocations), some are the types that must be done relatively soon to prevent further damage from occurring. ACL reconstruction is a good example of a surgery that should be done within the first few weeks to prevent further damage. For these types of surgeries, it is often best to undergo surgery right away, recover as quickly as possible, and give yourself as much time as you can to get back to 100% prior to the upcoming season.

With surgeries or injuries that can wait prior to addressing them, it is certainly reasonable to have surgery after the season. In this case, I usually ask the player and his parents to think about which season or seasons truly matter. Even when an athlete plays a sport year-round, there is usually one of those seasons that is not as big of a deal. I usually recommend that the athlete have surgery at the end of the last important season and give himself three or four months to recover by sitting out the season that doesn’t matter as much. For some athletes, the high school season might be most important, while for others, the club or travel season is the most important. A thorough discussion between the athlete, his parents, and the physician can help to make the best decision regarding timing of surgery in sports.