MLB Postseason Puts Players’ Endurance to the Test
Oct 4, 2017 - 12:02:32 PM
High velocity pitching can trigger shoulder, elbow injuries
“Throwing a baseball, sometimes in excess of 100 mph, generates high rotational velocity at both the shoulder and elbow. This can create friction and inflammation in these joints. This is why starting pitchers commonly pitch every five days; it’s considered a rare and special occurrence when a pitcher pitches on ‘three days’ rest.’ Most soreness and discomfort associated with a long pitching outing resolves with the appropriate rest and rehabilitation following a start.
“Injury to the shoulder in baseball typically occurs as a cumulative effect of throwing. Repetitive microtrauma can create damage to the labrum and rotator cuff of the shoulder. Most of these overuse-type injuries can resolve with a period of rest and rehabilitation, but sometimes structural damage in the throwing shoulder requires surgical intervention with arthroscopic shoulder surgery.
“Pitchers’ elbows are subject to high stresses, too. The ulnar collateral ligament stabilizes the elbow in the late cocking, early acceleration phase of throwing, and injuries to this ligament are very common in professional pitchers. Partial injuries to the ligament are treated with biological treatments such as stem cell injections and platelet-rich plasma injections, but complete ruptures require surgical reconstruction.”
Seth Gamradt, MD, who is the director of Orthopaedic Athletic Medicine for USC Athletics and a team physician for the USC Trojans, specializes in shoulder, knee and elbow surgery at Keck Medicine of USC.
Repetitive twisting and bending can take a toll on baseball players’ backs
“When MLB baseball players reach the postseason, the cumulative physical stresses of playing game after game can take a toll on their bodies. Baseball players often place a lot of stress and rotation on their spines because of the demands of playing baseball, including twisting and bending forces. This can put them at risk for soft tissue injuries like muscle strains or tears as well as intervertebral disc issues like bulging or herniated lumbar discs. These types of injuries can cause significant back pain or pain that radiates down the legs.
“Soft tissue injuries are typically treated with rest, stretching to allow recovery, then aggressive strengthening exercises and physical therapy to make the muscles stronger and to allow for a quicker recovery. Lumbar disc problems are treated by first controlling the inflammation of the disc and the nerves, and then beginning a rehabilitation process to strengthen and stabilize the spine. Oftentimes, anti-inflammatory medications and epidural injections are then needed to really quell the inflammation and allow for the recovery process. If the conservative treatments fail for disc herniations, a minimally invasive microsurgery can often alleviate the problems.”
Jeffrey C. Wang, MD, is an expert in surgical treatment of neck and back disorders. He is co-director of the USC Spine Institute at Keck Medicine of USC.
Elbow injuries are on the rise
“Baseball players face unique physical challenges. The throwing motion in baseball, in particular, is a repetitive movement that’s performed hundreds of times over the course of a day, thousands of times over the course of the season and tens of thousands of times over the course of a career.
“There’s a fine line between performance and injury, and the typical throwing motion puts tremendous stress on the body’s tissues. Over time this can lead to tendon injuries, cartilage tears or instability at the elbow or shoulder. While recent studies show that shoulder injuries are trending downward in professional baseball players, elbow injuries are trending upward.
“When players come to physical therapists for an elbow injury, symptom control is critical. Then, as symptoms begin to subside, work begins on the entire kinetic chain of throwing, including optimizing all of the moving body segments from the toes all the way to the fingers and ball release. The final stages of a player’s return to throwing involves an interval throwing program — a structured and staged progression of throwing repetitions and distance. Physical therapists play a vital role in the sports medicine and rehabilitation team in preparing a player to return back to throwing, hitting, running or fielding.”
Jonathan C. Sum, DPT, OCS, SCS, specializes in treating sports-related injuries, orthopaedic disorders, postsurgical rehabilitation, pain management and musical performance–related injuries through the Division of Biokinesiology and Physical Therapy. He is the clinic director of USC Physical Therapy Associates – Health Sciences Campus.
Sleep is being recognized as a key to optimum athletic performance
“Sleep, along with physical conditioning and conscious eating, plays a major role in athletic performance and competitive results. A 2009 study in the journal Sleep confirms the role of sleep in performance: The study found that sleep deprivation negatively affected split-second, or ‘gut-feeling’ decision-making, while adequate sleep improved it.
“Sleep has gained a lot of attention in the sports world, and teams from all sports are finding ways to help players improve their athletic performance with sleep. Earlier this year, a soundproof 'sleep room,' featuring pillows that have been customized to each player, was installed in Fenway Park after the team consulted with a sleep specialist. Other teams are turning to wearable technology to monitor the sleep and health of their athletes. By providing information the players can visualize, wearable technology has the potential to encourage better sleep habits. Professional teams are also emphasizing the use of strategic napping and the importance of sleeping well after a game, practice or other training event to enhance muscle recovery.
“The quality and amount of sleep athletes get is often the key to winning. A good sleep plan for professional athletes will maximize accuracy, improve reaction time and decision-making, increase speed and alertness and prolong the amount of time it takes to reach exhaustion.”
Rajkumar Dasgupta, MD, specializes in pulmonology, critical care and sleep medicine at Keck Medicine of USC.