Injuries to the shoulder account to the majority of injuries to baseball players. Most
of these injuries occur during the throwing motion. Acromioclavicular problems commonly
begin with an acute injury such as shoulder seperation. Regardless of the severity, most athletes
with shoulder seperation can return to their sport within a few weeks. Initial treatment
should include antiinflammatory medications and steroid injections.
Implingement, the most common ijury that occurs on the shoulder from throwing result
from the constant irritation of anterior shoulder structures. These structures make up
the roof of the anterior glenohumeral joint. The treatment during the early stages consist of rest,
nonsteroidal inflammatory drugs and rotator cuff strengthening exercises with the arm at one side.
Rotator cuff disease has extrinsic and intrisic etiologies. The extrinsic causes are forces
actly outside the rotator cuff that cause injury to the tendons. Implingement syndrome, in
which 95% of rotator cuff tears is an example of extrinsic rotator cuff disease.
Conservative treatment results in improvement of the sympotoms in most cases. Both the
rotator cuff scapular rotator muscles are weak and must be strengthened. Surgery to reconstruct
the anterior labrum and capsule may be required if physical therapy fails. Intrinsic causes
of rotator cuff disease include traction injuries. Throwing in baseball subjects the rotator
cuff to many insults (implingement, traction, and contusion), which can result in failure of tendon
fibers. Proper rehabilitation of the rotator cuff is essential for full recovery from a shoulder
injury.
Baseball can sustain a pleuthera of injuries to the elbow. The repetitious, high velocity
nature of the baseball throw induces chronic stresses at the elbow and predisposes the elbow
to overuse syndrome. Commonly overuse injuries are encountered when the bodies physiological
ability to heal lags behind trauma. A significant tension force is absorbed by the medial
elbow restraints during the late acceleration phases of the throwing cycle. Chronic trauma to
these structures can result in inflammation, scarring the medial colateral ligaments with
possible rupture. Treatments of these injuries depends on the integrity of the medial ligament
and the degree of joint instability. Treatment depends on the goals of the athlete, however,
surgical reconstruction for ruptures of the medial collateral complex is usually necessary.
Baseball, although not considered a full contact sport, results in surprisingly high numbers of head and neck injuries. The mechanisms of head and neck injury in baseball include ball impact, collision trauma and sliding accidents.