Wednesday, November 2, 2011

Baseball Pitching injuries: Dont forget about the Latissimus Dorsi and Teres Major!

Management and Outcomes of Latissimus Dorsi and Teres Major Injuries in Professional Baseball Pitchers

Background: Very little data exist on latissimus dorsi (LD) and teres major (TM) injuries in professional baseball pitchers.

Purpose: This review was undertaken to report on the management and outcomes of baseball pitchers with injury to 1 or both of these muscles.

Study Design: Case series; Level of evidence, 4.

Methods: A retrospective review of 16 professional baseball pitchers diagnosed and treated for an LD and/or TM tear between 2002 and 2008 was performed. Magnetic resonance imaging confirmed the diagnosis in all cases. The mean age was 28.1 years. All were treated nonoperatively with rest, rehabilitation, and return to pitching after a throwing program. The injuries included tendon avulsions in 6 athletes and strains in 10. Length of disabled time, return to prior level of pitching, and recurrences were noted.

Results: Fifteen of 16 pitchers (94%) returned to the same or higher level of play. The mean time to throwing was 35.6 days. Mean time to pitching was 61.9 days. Nine of 16 injuries (56%) were season-ending. Mean total time lost for athletes returning the same season was 82.4 days. Two of 16 pitchers (13%) sustained recurrent injuries. Prior shoulder and elbow injuries were noted in 75% (12 of 16).

Conclusion: Injury of the LD and/or TM can occur in pitchers. Nonoperative treatment is successful in allowing a return to high-level pitching.

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