Shoulder injuries and diseases


Baseball and shoulder


Introduction: Baseball and shoulder
One of the best scientifically evaluated sports for shoulder injuries and sport specific lesions of the shoulder in baseball and softball. About 20% of the sports medical literature in baseball is dealing with injuries of the shoulder. Extreme ranges of motion, high velocity power and extreme torsions occur while pitching.


Baseball and shoulder instability:
A common shoulder problem in baseball players is an instability. Complete dislocations are rare. Most common are chronic instability due to longlasting ( for years ) baseball. The shoulder capsule is stretched and the labrum worn off due to microtraumata, occuring for years during baseball training and competiting games. Snapping of the shoulder with concomitant shoulder pain develops. In these cases special sportsphysiotherapeutic programes are started. If this doesn´t work an arthroscopic stabilitzation procedure will be performed using techniques like capsular plication, Bankart suture and so on.


Partial tears and SLAP lesions of the shoulder in baseball:
Quite often the reason for shoulder pain in a baseball players might remain unclear. In these sportsmen partial tears of the rotator cuff, SLAP lesions and a posterosuperior impingement might be the cause of the problems. SLAP lesions are tears of the labrum at the upper rimb of the bony glenoid. Depending on the type of SLAP lesion they will be debrided or sutured, arthroscopically. After a SLAP 2 lesion about 85% of the baseball players return to sports, performing the baseball activity on the preinjury level.


Special forms of impingement of the shoulder in baseball:
Often, a shortening of the posterior shoulder capsule is observed. In addition a diminished external rotation of the bladebone might be responsible for additional shoulder problems.
Other shoulder diseases are an impingement syndrome and an inflammation of the long head of the biceps tendon. Most of the time it´s an internal impingement. Performing an abduction and external rotation, for example while throwing a ball, the rotator cuff is impinging between the humeral head and bony glenoid in the posterosuperior region, thus causing shoulder pain. This is associated with an instability which has to be adressed also, arthroscopically.


The " Little League shoulder ":
"Little League Shoulder" are affections of the growth plate at the humeral head. Rarely, these injuries occur in children or young adults while playing baseball. Pitching with curved balls and sliders are not advisable in the age group between 10 and 15 years, because injury risk is present. If baseball is started in early youth humeral torsion is adapting to this situation. Which means that external rotation capability is increased, throwing balls is done more effective and internal rotation is diminished. About 50% of all juvenile baseball players are complaining about shoulder pain. To prevent injuries there numbers / advises of 75 pitches per game and 300 pitches a season in the sports medical literature.


What can I do for my shoulder having complaints in baseball ?
First of all, rest of sports, physiotherapy and pain / antiinflammatory medication are the methods of choice, if shoulder injuries or the above mentioned diseases occur. Stretching exercises for the posterior capsule and for the scapula are very important. The more professional the baseball sports is performed the more important are these stretching exercises.


What can be done otherwise for my shoulder ?
If nonoperative therapy does not work a shoulder arthrocopy is done, combined with an arthroscopic procedure, depending on the individual situation in the shoulder joint.
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