Baseball Shoulder Injuries

This time of the year, every year, the men in my family are watching baseball. It reminds me of the many men I see who are in their 50s and beyond, who suffer from chronic shoulder pain.  Many of these injuries were sustained years ago when they played baseball.  I thought that I would talk about some of the more common throwing injuries: rotator cuff tears and tendinitis.

First, let’s go over a bit of shoulder anatomy. The glenohumeral joint is a ball and socket joint with the widest range of motion of any joint in the body. Ligaments, the joint capsule and the labrum hold the joint in place at rest. With movement, the rotator cuff and biceps tendon provide important joint stability. The rotator cuff is a group of 4 muscles, each one having a specialized function; they work together to control shoulder motion.

The motion of overhead throwing or pitching can be divided into 6 phases: windup, early cocking/stride, late cocking, acceleration, deceleration, and follow-through.

Good execution of the windup and stride phases is primarily dependent on lower body issues. True, a “late arm” can occur in the early cocking or stride phase, but this problem is corrected by adjusting the leg and foot positions.

We begin to see the shoulder get into trouble during the late cocking phase when the shoulder externally rotates. High degrees of external rotation can increase ball velocity but can also lead to posterior shoulder impingement. In throwers, this usually means that the infraspinatus tendon gets caught between the head of the humerus and the glenoid bone. Over time, the infraspinatus tendon can tear.  Additionally, over years of repetitive throwing, the anterior shoulder ligaments stretch and loosen, leading to shoulder instability. The posterior ligaments get tighter and that impairs internal rotation, leading to rotator cuff tears.

The biceps tendon is important in stabilizing the humerus during late cocking, deceleration  and follow-through phases, acting as a brake and as an anterior stabilizer for the humerus. The higher the speed at which the ball is thrown, the greater the risk of injury to the bicep tendon and muscle.

So, years of overhead throwing (baseball, football or volleyball) can lead to chronic shoulder injuries. As we age, we get the added insult of degenerative changes at the acromion leading to reduced size of the subacromial space. This causes compression of the rotator cuff, inflammation (tendinitis) and eventually, rotator cuff tears. Overhead activities in adulthood can also increase the risk for impingement. Being a hairdresser, carpenter or painter, swimming, playing handball, or volleyball are common examples.

What can you do if you have shoulder pain and have been diagnosed with a rotator cuff issue? Well, there’s always surgery. But rotator cuff surgery is infamous for the lengthy and painful post-operative recovery. At the Regenexx® office in Camp Hill, we will evaluate you and give our advice on non-operative care. After a physical exam, an ultrasound exam and review of all imaging studies we will help you to decide if one of our Regenexx® procedures is right for you. Many times, PRP (platelet Rich Plasma) can treat small rotator cuff tears, tendinitis and early arthritis.  For more advanced arthritis, larger rotator cuff tears we may recommend an injection with bone marrow concentrate, which contains stem cells. A faster recovery gets you back to your favorite sports and hobbies in less time, and you’ll miss less work.

Call Regenexx® at Advanced PainCare today at 717-791-2860 or 717-864-6985. We’re conveniently located one block from Market Street in Camp Hill, PA.

References:

  • Busconi, Brian and Stevenson, J. Herbert, Sports Medicine Consult, Philadelphia, 2009, p. 90.
  • Creech, J, Silver, S, StatPearls (Internet). StatPearls Publishing: Treasure Island FL. April 17, 2023. Shoulder Impingement Syndrome.
  • Diffendaffer, A, et al, American Sports Medicine Institute, Birmingham, AL. Mar-Apr 2023. The Clinician’s Guide to Baseball Pitching Biomechanics.

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