Symposium: Injuries in Overhead Athletes 13 articles
Return to Play After Type II Superior Labral Anterior-Posterior Lesion Repairs in Athletes: A Systematic Review
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
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
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 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
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.
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.
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.
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.
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?
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.