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BASEBALL’S MOST FEARSOME INJURY Michael Hornbuckle, ATC, CWCE, FAFS In over 25 years of baseball, I’ve heard this story too many times to count… A high school pitcher has great velocity and pop in his Sophomore season, but during his Junior year, his velocity drops by 10 miles per hour, and is missing it’s zip. Every baseball player knows that they typically play the game with some shoulder pain, and tend to live on a regimen of ibuprofen during the season, but this type of situation normally draws the question, “What happened?” This is when the plot tends to thicken. The conversation has to happen that the athlete may have suffered a significant injury: a torn labrum. A piece of fibrocartilage in the shoulder, the labrum cushions the top arm bone (the humerus) against the socket known as the glenoid. Having it securely in place is vital for throwing, and the most common solution is surgery to repair a tear in it. From a layman’s perspective, the labrum is a pretty simple stabilizer to the shoulder joint. It creates a suction seal. It’s like an O-ring on a valve. The labrum tear as baseball’s “most fearsome injury,” and rightfully so. About half of major leaguers don’t return to form. It is most commonly a career ender, as in the case of Mark Prior, but some do make it back. Trevor Hoffman was a star relief pitcher with the San Diego Padres when he tore his labrum and had surgery. He returned to be just as dominant and ended up in the Hall of Fame. All of the force generated to throw a ball travels from the stance leg, through the hip and back and into the arm and shoulder joint. If the labrum isn’t sealing right, there could be instability, which translates to pain and a dip in performance. Many times this is a significant dip in velocity and the feeling like a dead arm, or even sharp pain. But instability isn’t just related to pain. Stability provides proprioception, or knowledge where the arm is in space. It also lets the athlete subconsciously know where exactly to place the ball by the feedback it provides to the brain. There is a concept of good SLAP (Superior Labral tear from Anterior to Posterior) and bad SLAP. Good SLAP happens when the labrum stretches and results in more range of motion than is typical of experienced throwers. Bad SLAP is more significant separation and extends further down the back of the glenoid (shoulder socket), and results in instability. While bad SLAP usually needs to be fixed by surgery, the issues that caused the labral tear in the first place can potentially be remedied through things like physical therapy. Whether it is a good SLAP, or just shoulder pain, the problem could typically be poor scapular mobility, tight hips or quads, and potentially even limited ankle motion in the stance leg to name a few. These issues must be addressed to ensure that recurrence of the injury is unlikely. Issues can linger for a thrower whose labrum has been torn. Every torn labrum that gets repaired tends to have SOME loss of motion in the shoulder. This motion can and does improve with time, but the need for continued arm care exercises is very important to keep the shoulder healthy after injury or surgery. So why are labrum injuries career-killers for some but just a bump in the road for others?
Keep up with your physical therapy exercises to relieve pain and prevent further injuries. If your pain doesn’t subside, consult with your therapist about what other things might be causing pain. Call Trademark Performance for a complimentary injury consultation. We will guide you so you can get back to the activities you love. HAS YOUR PA I N COME BACK? 1 2 3 CLINIC NEWS REMOTE PERSONAL TRAINING I S NOW L I V E !
If you have shoulder pain, we can give you advice and help start the process of recovery.
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