Shoulder Surgery Not the Best Option for Baseball Players

Shoulder injuries are common in athletes, especially baseball players. But shoulder surgery is frequently not successful. New research suggests non-surgical treatments may actually be most effective.

Many athletes have their career ended abruptly due to shoulder injuries. Baseball players especially place a lot of stress on the shoulder and, unfortunately, many times they end up paying for it in the form of a SLAP tear. (SLAP stands for superior labrum anterior and posterior.)

Currently, there are options for surgical repair for a SLAP tear, but there is no guarantee the athlete is going to make a full recovery. The procedure for repair varies widely and most times does not allow for the player to return playing at the same level as before the injury. Fortunately, researchers from Methodist Center for Sports Medicine in Houston, Texas suggest that non-surgical treatment may be more beneficial than the surgical options available today.1

David Lintner, MD led a team in a review of 119 professional baseball players who had persistent shoulder pain that limited their ability to compete. Sixty-eight of the players had documented MRIs that showed SLAP lesions and had failed physical therapy. Initially, all patients were treated with non-surgical techniques according to an algorithm focused on correcting the scapular dyskinesia and posterior capsular tightness.2

Abnormal movement of the shoulder blade (scapula) is known as scapula dyskinesis. This occurs in a variety of shoulder problems. It is an important sign of an underlying shoulder disorder and a guide to shoulder rehabilitation.3 Posterior capsular tightness is a common cause of shoulder pain in which the patient has restricted internal rotation and pain. Patients often have pain that mimics that reported with impingement syndrome.4

Among the sixty-eight players who had SLAP lesions, forty five were pitchers. The return to competition seemed to happen at a higher rate (73%) for position players compared to that of pitchers (40%). “Our research showed that nonsurgical treatment of SLAP tears was more often successful than surgery, and in position players more frequently than for pitchers,” said Lintner. “We need more research to determine why the nonsurgical treatment was more beneficial to one population than the other, but our findings did illustrate that nonsurgical treatment should be preferred.”5

“Returning to the same level of competition as before the injury, is almost always difficult for an athlete, and surgery is often thought of as the best avenue. With additional research, orthopedists are finding different routes to treat some of the most common throwing injuries,” said Lintner.6

Based on this research, it may come to be that shoulder surgery may not always be necessary for baseball players. The idea of surgery is often accompanied with negative connotations, especially with pitchers, since they never seem to fully bounce back to their full potential. Hopefully as more research is conducted, shoulder surgery for baseball players, or athletes with the same injury, will be a thing of the past.

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