EMPOWER
MD Clinical Education Series
Dr. Scott o'Neil
ACL, Knee & Shoulder Stability
We sat down with Dr. Scott O’Neal, an orthopedic sports surgeon with OrthoCarolina, to review current updates in sports medicine and how surgical decision-making directly influences rehabilitation quality, performance, and long-term outcomes.
Dr. O’Neal is highly collaborative with physical therapists and practices in alignment with our Athletic Performance Therapy model. His approach prioritizes movement quality, objective strength benchmarks, and respect for tissue biology rather than arbitrary timelines. Our discussion included ramp lesions and lateral extra-articular augmentation (LET/ALL) in ACL reconstruction, evidence-based return-to-sport timing, and shoulder instability management, including the role of remplissage in addressing Hill-Sachs lesions.
Appropriate referrals include athletes undergoing ACL reconstruction, particularly female athletes, hyperlax patients, revision cases, or high-risk cutting athletes. He also frequently manages athletes with recurrent shoulder instability, Bankart lesions, or large Hill-Sachs defects where surgical strategy can significantly impact motion, confidence, and long-term performance, especially in overhead athletes.
Clinic Location: OrthoCarolina – Ballantyne / South Charlotte
High School: Ardrey Kell
Contact: Dr. Scott O’Neal 305-450-5445
His biggest pet peeve?
His biggest frustration is when rehabilitation progress becomes unclear and communication does not happen. Dr. O’Neal prefers early outreach from PTs if progress stalls or symptoms do not align with expectations, rather than teams working independently.
The best way to reach him is direct communication by text with patient information or clinical questions.
Key takeaways for our team:
Return to sport is a performance decision, not simply a timeline. Quad symmetry, movement quality, and objective testing carry more weight than reaching six or nine months post-operatively.
Shoulder stabilization procedures require rehabilitation nuance. Techniques such as remplissage can significantly reduce re-dislocation risk but may affect overhead athletes differently. Thoughtful progression, clear communication, and expectation setting are essential within the APT framework.
Empower: MD Clinical Education Series
Empower is an internal clinical education series for our staff. Alan and Sydney sit down with local physicians we work with to better understand how they approach cases, when they prefer referrals, and how we can communicate more clearly and earlier in the process.
These are real conversations about surgical decision-making, injury management, and return-to-play planning. The goal is simple. Help you grow as a clinician and help us serve our patients better.
This is part of our ongoing commitment to development and investment in our team.