Arm, Shoulder Injuries
Martin Kelley, P.T., D.P.T., O.C.S.
Did you know that up to 91 percent of competitive swimmers have reported experiencing shoulder pain? Unfortunately most young swimmers will develop such pain—it’s just part of the sport.The same used to be true of youth pitchers in baseball.
For years, there was growing evidence that youth baseball pitchers were experiencing a high number of shoulder and elbow injuries. These injuries appeared related to excessive exposure to throwing the baseball. It was an epidemic, a talented 13-year old kid’s future ended due to shoulder and/or elbow ligamentous injuries. It got to a point where these kids and their parents were coming to orthopaedic surgeons for the elbow-saving Tommy John surgical procedure. Enough was enough.
In the beginning of 2007, Little League baseball became the first organization to implement a pitch count rule to protect young pitching arms. This is an age-based system in which a pitcher who throws a certain number of pitches must wait several days before competitively throwing again. Even Major League Baseball managers follow pitch counts to protect multi-million dollar shoulders from injury.
Julie Mayberry, M.D.
I wanted to open a discussion regarding association of wrist pain and exercise that requires increased weight bearing on upper extremities. In my practice, I see patients from mixed demographics with complaints of wrist pain. In fact, wrist pain happens to be one of the most searchable conditions on the Internet.
A large number of patients associate wrist pain with increase or change in exercise activity—sometimes, a newly developed love for yoga or Pilates.
With multiple benefits comes the unfortunate side effect: pain in the least expected locations such as wrist, elbow and shoulder joints. While this phenomenon is more common in women, we are beginning to see an increasing occurrence in men. How can physical activity that has been praised for thousands of years for bringing emotional and physical well being cause its followers pain and injury?
Justin Shaginaw, M.P.T., A.T.C.
For statistics on common baseball injuries, click here.
It’s that time of year. Spring sports are in the air, even if the spring weather isn’t. Let’s head to the ballpark and start with baseball.
Robert Senior, Sports Doc blog Editor
This Saturday, the Phillies and Rothman Institute will host the 6th annual Sports Medicine Symposium at Citizens Bank Park.
The event, which begins with registration and continental breakfast at 6:30 a.m., is targeted for sports medicine physicians, physical therapists, certified athletic trainers and other professionals. Sports Doc panelist Dr. Michael Ciccotti, Director of the Sports Medicine team at Rothman Institute and head team physician for the Phillies, will present along with fellow Rothman Institute sports physicians and Phillies Certified Athletic Trainers and strength/conditioning coaches.
“We’ll be looking at common sports injuries—specifically, those in the overhead and the throwing athlete,” says Dr. Ciccotti.
Justin Shaginaw, MPT, ATC, Aria 3B Orthopaedic Institute, Athletic Trainer - US Soccer Federation
Poor swimming mechanics may be a contributing factor in many swimming injuries. But assessing these mechanics is beyond the expertise of most sports medicine. Your swimming stroke should be assessed by your coach, taking into account your specific injury, in order to eliminate an underlying biomechanical cause. A team approach should be taken with swimming injuries incorporating these stroke changes along with a specific rehabilitation program from your athletic trainer or sports medicine provider.
Brian Cammarota, M.Ed., ATC, CSCS, CES
Throwing a baseball or softball is one of the most difficult activities in sports and requires extreme accuracy and skill. It is also one of the most unnatural motions in sports and leads to many injuries, especially among baseball pitchers.
The speed of the pitching shoulder in baseball has been shown to reach 6900 degrees per second in youth pitchers (and higher speeds in adult pitchers). That is equivalent to spinning your arm in a circle approximately 19 times in 1 second (or about half the time it took to read this last sentence). With speeds that fast, it is no surprise that shoulder and elbow injuries are common. One way to decrease injury risk is to perform an off-season throwing program that gradually builds arm strength and prepares a thrower or pitcher for their season.
Two common mistakes among baseball and softball players are:
Alfred Atanda, Jr., M.D., Nemours/Alfred I. duPont Hospital for Children.
For those of us that follow baseball, it seems like every time we turn around another pitcher is going down with a major injury. The most recent notable name is Matt Harvey from the New York Mets. Like many before him, he started having pain with pitching while experiencing decreased velocity and poor control of his pitches.
After visiting with several doctors, he was eventually diagnosed with an Ulnar Collateral Ligament (UCL) tear of his elbow. After seeking advice from several other pitchers with a similar injury, including the Phillies’ Roy Halladay, he eventually decided to undergo “Tommy John Surgery” or UCL reconstruction. Rather than try non-operative treatment, he elected to undergo surgery to maximize his chances at returning to the mound and be as competitive and dominant as he once was.
These clinical scenarios are not only common, but they can get a lot of media attention depending on the caliber of the pitcher involved. With increased attention, increased misconceptions are developed as well usually because a lot of the medical information is interpreted out of proper context. Lately, in my office, I’ve been seeing a lot young pitchers with minimal elbow pain and discomfort terrified that they may need Tommy John Surgery and miss a year of pitching. I’ve had other pitchers, and even parents and coaches, ask if they should have Tommy John Surgery in the absence of an injury, in efforts to try to increase velocity and control.
Heather Moore, PT, DPT, CKTP, Owner of Total Performance Physical Therapy, North Wales, Pa.
“What should I do? Heat or ice?”
The amount of times I have been asked this could qualify for the Guinness Book of World Records. The most confusing part for people is that if you ask 20 different health care professionals, you will get 20 different answers because the literature varies on this—as do most people’s experiences and preferences on what to tell their patients.
There are a few general rules that I tell my patients to follow as guidelines for when to use heat or ice. The first—and this most, if not all healthcare practitioners will agree upon—is that 24-48 hours after sustaining an injury, ice should be applied. This is where RICE (Rest, Ice, Compression and Elevation comes into play. After the 48 hours, we enter that gray area.
- Alfred Atanda, Jr.
- Arm, Shoulder Injuries
- Ashley Greenblatt
- Back Injuries
- Brian Cammarota
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- David Berkson
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- Desirea D. Caucci
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- Head Injuries
- Heather Moore
- In The News
- Jim McCrossin
- Joel H. Fish
- John Quinn
- Julie Coté
- Justin Shaginaw
- Kelly O'Shea
- Kevin Miller
- Knee Injuries
- Michael G. Ciccotti
- Other Sports
- Performance Enhancement
- Peter F. DeLuca
- Philadelphia Marathon
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- Physical Therapy
- R. Robert Franks
- Robert Cabry
- Robert Senior
- Rock 'n' Roll Half Marathon
- We Tried It
- Working Out