JOCK DOC

High school pitcher injures his arm — what’s next?

 

HarlanS@baptisthealth.net

Q.My son is a 17- year-old baseball player who hurt his right shoulder. Last season he was an infielder but this season he became a pitcher. About a month ago, he injured his right shoulder while throwing. The injury took about a week to happen and we rested it for a week and it still bothered him and we saw our pediatrician.

The pediatrician got an MRI scan, which showed a tear of the subscapularis muscle and he was sent to physical therapy. After about two weeks he went back to throwing but the shoulder again became sore and he was unable to pitch.

I then brought him to an orthopedic surgeon who said he needed to rest the shoulder for a couple of months and we are concerned that he is going to miss this baseball season. Does this sound like the right treatment and what can we do to get him to play sooner?

A. There are four muscles that make up the rotator cuff tendon that allow us to rotate the shoulder. The subscapularis portion of the rotator cuff tendon is less frequently injured and it is an internal rotator of the shoulder. In the throwing athlete, it is usually the tendinous portion of the subscapularis where it attaches to bone that is injured. If a significant subscapularis tendon tear occurs, it often requires arthroscopic surgical repair and a period where he can’t throw from six months to one year.

Your son appears to have a less common injury, which is a tear of the muscular portion of the subscapularis. Muscle tears can result in pain and weakness and usually require a significant period of rest and physical therapy for them to get better. Usually muscle tears will heal non-surgically.

After a period of rest to decrease the inflammation and swelling, the patient gradually works to restore normal motion and then works on a gradual strengthening program. It is common for this injury to take at least several months to heal. I do agree that this baseball season may be in jeopardy for your son.

If you are unsure of the diagnosis or timeframe, you may want to discuss this further with your current doctor or get a second orthopedic surgical opinion.

When your son returns to playing, it is very important that proper warm-up and conditioning is emphasized as well as proper throwing mechanics to decrease the risk of re-injury in the future.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to HarlanS@baptisthealth.net

Read more Health stories from the Miami Herald

  • Plastic Surgery 101

    Plastric surgery 101: Puffy eyes can happen to younger people

    Q. I'm 25 and hate the way my eyes look! I know that I'm going to need to get my eyes done but am I too young? I have very puffy eyes in the morning and during the rest of the day they remain puffy. Is there anything I can do now or do I have to wait until I am in my 40s?

  • JOCK DOC

    Jock Doc: New advances in hip-replacement surgery can help in the long term

    Q. I have been having hip pain that has gotten worse for several years. I saw my orthopedic surgeon, who said I had bad arthritis and needed a new hip. I have been reading online about minimally invasive hip surgery, robotic hip surgery and traditional hip surgery. Do you have any advice on what I should do?

  • Fit Tip

    Fit tip: Do compression sleeves work?

    Q: I twisted my knee recently. Do compression sleeves work to help recover from an injury? 

Miami Herald

Join the
Discussion

The Miami Herald is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere on the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. Thank you for taking the time to offer your thoughts.

The Miami Herald uses Facebook's commenting system. You need to log in with a Facebook account in order to comment. If you have questions about commenting with your Facebook account, click here.

Have a news tip? You can send it anonymously. Click here to send us your tip - or - consider joining the Public Insight Network and become a source for The Miami Herald and el Nuevo Herald.

Hide Comments

This affects comments on all stories.

Cancel OK

  • Marketplace

Today's Circulars

  • Quick Job Search

Enter Keyword(s) Enter City Select a State Select a Category