Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Symposium: Injuries in Overhead Athletes 13 articles


Return to Play After Type II Superior Labral Anterior-Posterior Lesion Repairs in Athletes: A Systematic Review

William M. Sayde MD, Steven B. Cohen MD, Michael G. Ciccotti MD, Christopher C. Dodson MD

Superior labral anterior-posterior (SLAP) lesions are a common cause of pain and disability in athletes. Individual studies have suggested low patient satisfaction with SLAP repairs in throwing athletes in particular and it is unclear how frequently athletes return to their previous level of competetion.

Surgical Technique Arthroscopic Posterior Glenoidplasty for Posterosuperior Glenoid Impingement in Throwing Athletes

Christophe Lévigne MD, Jérome Garret MD, Sophie Grosclaude MD, Florent Borel MD, Gilles Walch MD

Posterosuperior glenoid impingement (PSGI) is the repetitive impaction of the supraspinatus tendon insertion on the posterosuperior glenoid rim in abduction and external rotation. While we presume the pain is mainly caused by mechanical impingement, this explanation is controversial. If nonoperative treatment fails, arthroscopic débridement of tendinous and labral lesions has been proposed but reportedly does not allow a high rate of return to sports. In 1996, we proposed adding abrasion of the bony posterior rim, or glenoidplasty.

Passive Range of Motion Characteristics in the Overhead Baseball Pitcher and Their Implications for Rehabilitation

Kevin E. Wilk PT, DPT, Leonard C. Macrina MSPT, SCS, CSCS, Christopher Arrigo MS, PT

Repetitive overhead throwing motion causes motion adaptations at the glenohumeral joint that cause injury, decrease performance, and affect throwing mechanics. It is essential to define the typical range of motion (ROM) exhibited at the glenohumeral joint in the overhead thrower.

‘Batter’s Shoulder’: Can Athletes Return to Play at the Same Level After Operative Treatment?

Tony Wanich MD, Joshua Dines MD, David Dines MD, Ralph A. Gambardella MD, Lewis A. Yocum MD

Batter’s shoulder has been defined as posterior subluxation of the lead shoulder during the baseball swing. However, it is unclear whether or how frequently patients may return to play after treatment of this uncommon condition.

Glenoid Stress Distribution in Baseball Players Using Computed Tomography Osteoabsorptiometry: A Pilot Study

Tomohiro Shimizu MD, Norimasa Iwasaki MD, PhD, Kinya Nishida MD, PhD, Akio Minami MD, PhD, Tadanao Funakoshi MD, PhD

It is important to understand the loading conditions when considering the pathology of shoulder disorders in overhead athletes. However, because throwing is a complicated motion and methods to directly determine stress distribution are complex, direct measurement of the stress distribution across the glenohumeral joint has not been attempted. Subchondral bone density reportedly reflects the cumulative stress acting on a joint surface under actual loading conditions.

Hip Injuries in the Overhead Athlete

Gregory G. Klingenstein MD, RobRoy Martin PhD, PT, CSCS, Ben Kivlan PT, SCS, OCS, CSCS, Bryan T. Kelly MD

The overhead athlete is at risk for shoulder and elbow injuries. However, the mechanics associated with overhead sports also place athletes at risk for hip injuries. Advancements in hip arthroscopy have identified femoroacetabular impingement (FAI) and instability as potential contributors to labral and chondral pathology in this athletic population.

An Acute Throwing Episode Decreases Shoulder Internal Rotation

W. Ben Kibler MD, Aaron Sciascia MS, ATC, NASM-PES, Stephanie Moore MS, ATC

Glenohumeral internal rotation (GIR) and total arc of motion (TAM) decrease, whereas external rotation (GER) may increase in throwing. Although decreased GIR has been documented after throwing, its time course for recovery and the effect of pitching role have not.

Reliability of Scapular Classification in Examination of Professional Baseball Players

Todd S. Ellenbecker DPT, MS, SCS, OCS, CSCS, W. Ben Kibler MD, David S. Bailie MD, Roger Caplinger ATC, George J. Davies DPT, SCS, ATC, CSCS, Bryan L. Riemann PhD, ATC

Clinically evaluating the scapulothoracic joint is challenging. To identify scapular dyskinesis, clinicians typically observe scapular motion and congruence during self-directed upper extremity movements. However, it is unclear whether this method is reliable.

Intraarticular Abnormalities in Overhead Athletes Are Variable

Ashvin K. Dewan MD, Juan Garzon-Muvdi MD, Steve A. Petersen MD, Xiaofeng Jia MD, PhD, Edward G. McFarland MD

The cause of shoulder pain and dysfunction in the overhead athlete can be variable. Several studies illustrate the wide variety of lesions seen at the time of arthroscopy in overhead athletes who require surgery but it is unclear whether these differ by sport.

Does Posteromedial Chondromalacia Reduce Rate of Return to Play After Ulnar Collateral Ligament Reconstruction?

Daryl C. Osbahr MD, Joshua S. Dines MD, Andrew J. Rosenbaum MD, Joseph T. Nguyen MPH, David W. Altchek MD

Biomechanical studies suggest ulnohumeral chondral and ligamentous overload (UCLO) explains the development of posteromedial chondromalacia (PMC) in throwing athletes with ulnar collateral ligament (UCL) insufficiency. UCL reconstruction reportedly allows 90% of baseball players to return to prior or a higher level of play; however, players with concomitant posteromedial chondromalacia may experience lower rates of return to play.