The Arsenal winger returned to London on Wednesday morning from England’s base in Berlin and immediately had a scan after being assessed by the club’s medical staff.
His shoulder was said to feel stiff and he saw a specialist last night to discuss whether to have surgery.
There was a strong feeling that an operation was the best course of action, given the potential for recurring dislocations. He is now expected to go under the knife within the next 48 hours and Arsenal manager Arsene Wenger said on Wednesday night he expected the player to be out for three months.
Walcott’s injury is to his right shoulder, but he has also had surgery on his left, and there is an acceptance that there has been a weakness in that area of his body.
Previously, he attempted to continue playing through the pain of successive dislocations, after suffering the initial problem way back in 2005 when Portsmouth defender Linvoy Primus landed on top of him during a reserve team game for Southampton.
The 19-year-old had a separation of his collarbone and left shoulder and had an operation to correct the hereditary problem last year. His left shoulder became dislocated as many as 20 times before it was decided to undergo surgery, but since then it has given him no problems.
There is, therefore, confidence that surgery on his right shoulder would also cure the problem, with a feeling that it might be better to have the problem dealt with as soon as possible. Earlier this month Walcott was taken off on a stretcher during Arsenal’s defeat at Stoke following a heavy fall.
Walcott, though, will digest all the medical advice before making a final decision.
The dislocation to his right shoulder was suffered after a challenge from Scott Parker in the dying minutes of England’s training session on Tuesday, ahead of the team's friendly with Germany.
Walcott’s absence will leave Wenger’s squad threadbare at a crucial point in their season. Bacary Sagna, Emmanuel Eboue, Eduardo and Tomas Rosicky are all on the treatment table for varying lengths of time. Given the comparatively small squad of senior players at the Emirates, adding Walcott to that list will be a heavy blow.
With a faltering Premier League title challenge to sustain and their place in the last 16 of the Champions League still far from certain, Wenger now faces a test of the faith he has in his fabled youngsters.
Only Samir Nasri of Arsenal’s first choice wide players is fit, meaning Wenger would have to consider throwin either Abou Diaby or Alex Song in as replacements. Alternatively he could give a starting role to Aaron Ramsey, the 18-year-old Welshman, or Jack Wilshere, the prodigy two years his junior who has done so well in the Carling Cup for the club.
The better news for England regarding Walcott is that the next game is not until a friendly in February followed by competitive matches in April and June against Ukraine and Kazakhstan.
What is a dislocated shoulder?
The shoulder is a ball-and-socket joint prone to instability, and it poses a particular concern for Theo Walcott, who has a hereditary problem. He dislocated his right shoulder in training in Berlin, but also had to have his left shoulder pinned in 2007. When he fell on it in the recent game at Stoke, he suffered spasms.
When the shoulder is rotated outwards – cocking your arm back – any extra force, such as the fall suffered by Walcott, can pop the humerus bone out of the joint. This is known as anterior dislocation.
How do you fix it?
As was the case with Walcott, a doctor must put the joint back into place immediately. The shoulder should then be immobilised in a sling for two to three weeks before a period of physiotherapy to build strength in the rotator cuff muscles in the shoulder. Doctors recommend sporting activity should be avoided for around six weeks to allow the injury time to heal.
Why does it take so long to heal?
The bone might go back in immediately but the ligaments around the bone are normally torn, while the shoulder cartilage and the fibrous capsule enclosing the joint could also be damaged. Recurring dislocations are likely because these structures, once damaged, never regain their original strength. Surgery is normally recommended after four dislocations.
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