4/11/06

Overhead Injuries

Overhead throwing Athlete injuries-namely the increase in SLAP Tears and UCL Tears in pitchers--baseball team I work with has 8 guys that have had UCL Reconstruction in the last 2-2 1/2 years. We have also probably had 8 SLAP Tears in from athletes in all our sports in the last 12 months. Both numbers just seem extremely high. Is there some type of programming that could be implemented that would help prevent these injuries?

Your pattern of injuries definitely reflects a national trend. I never heard of a SLAP tear before 1994. The all of a sudden it became the injury. Out team doctors for the White Sox wanted to examine every player for SLAP tears. My question was there really a problem or did we create a problem by looking for one? That seemed to get the ball rolling. As a non medical person who has the luxury of asking stupid questions I want to know if pitchers and for that matter other throwers always had them, but they threw through them or rested and rehabbed and they were able to tolerate them? I started asking the pitching coaches who had had been pitchers about this and their opinion was just that, they all had those symptoms at one time or another and thought it was just something they had to endure. So were they just tougher? I don’t think so. I think we have more sophisticated diagnostic methods (MRI) that show things that did not show before. There is more at stake from a monetary standpoint, big salaries and bonuses in professional baseball and liability at the college and high school level. All of that being said what can be done. Take the focus away from the rotator cuff. Do more core work in functional positions – standing and moving. Do more hip mobility and crawling. In short anything that can link the hip to the shoulder. Also make sure that they have sound pitching mechanics.

As far as UCL the numbers are high and increasing. Here is a problem that is two fold. 1) Too many breaking balls at a young age, kids should not be allowed to throw anything but a fastball and a change up until they are 14 – 15 years old. 2) Changes in grip to manipulate the pitches. This puts more stress on the elbow. There is also this crazy idea that has developed among young pitcher that they can come back throwing harder after the surgery. Another urban myth.

2 Comments:

At 4/12/06, 8:34 AM, Blogger Joe Przytula said...

A few years back we had a catcher diagnosed with MDI (multidirectional instability) of the shoulder. For those of you who don't know, MDI is a precursor to SLAP lesions.

The local orthopedists insisted reconstructive surgery was necessary. Being skeptical, I suggested he visit Dr. Luis Bigliani, NY Yankees orthopedist.

Dr. Bigliani said something interesting. "Surgery? Absolutely not! You need a loose shoulder to throw hard. Rehab him conservatively, as long as it takes."

Turns out he was right. He made all county the following year, and was the #2 ranked catcher in N.J.

Did his capsule tighten up by itself, or did the athlete regain his "mostability"?

 
At 4/18/06, 11:38 AM, Anonymous Anonymous said...

If you're looking for more information about SLAP tears, there's a great blog out there for you - www.slaptear.com

 

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