Effort Thrombosis in the Elite Throwing Athlete

DiFelice, Gregory S.; Paletta, George A.; Phillips, Barry B.; Wright, Rick W.

doi:10.1177/03635465020300051401

Cited by 56 publications

(45 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Currently, there are a limited number of case reports that address the less common injuries to baseball players. There are only approximately 15 case reports on neurovascular injury in baseball players, nine mainly addressing arterial injury [2,8,9,17,19,20,26,36,38,39], three that observed specifically thoracic outlet syndrome [11,12,37], and three that reported a combination of the two [31,32,39]. Although arterial injuries, including those resulting from thoracic outlet syndrome, are not reported frequently, it is important that healthcare professionals responsible for the care of athletes be diligent when evaluating patients with shoulder pain, even after initial diagnosis and prescription of treatment.…”

Section: Discussionmentioning

confidence: 99%

Case Reports: Unusual Cause of Shoulder Pain in a Collegiate Baseball Player

Ligh

Schulman

Safran

2009

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

The objective of reporting this case was to introduce a unique cause of shoulder pain in a high-level Division I NCAA collegiate baseball player. Various neurovascular causes of shoulder pain have been described in the overhead athlete, including quadrilateral space syndrome, thoracic outlet syndrome, effort thrombosis, and suprascapular nerve entrapment. All of these syndromes are uncommon and frequently are missed as a result of their rarity and the need for specialized tests to confirm the diagnosis. This pitcher presented with nonspecific posterior shoulder pain that was so severe he could not throw more than 50 feet. Eventually, intermittent axillary artery compression with the arm in abduction resulting from hypertrophy of the pectoralis minor and scalene muscles was documented by performing arteriography with the arm in 120°abduction. MRI-MR angiographic evaluation revealed no anatomic abnormalities. The patient was treated successfully with a nonoperative rehabilitation program and after 6 months was able to successfully compete at the same level without pain.

show abstract

Section: Discussionmentioning

confidence: 99%

Case Reports: Unusual Cause of Shoulder Pain in a Collegiate Baseball Player

Ligh

Schulman

Safran

2009

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Repetitive overhead arm movements or hyperabduction and external rotation of the shoulder are most usually implicated. [23][24][25] Repetitive injury causes perivenous fibrosis, which eventually leads to thrombosis. Compression of the venous structures that traverse the thoracic outlet occurs in two distinct areas: the scalene triangle and the costoclavicular area.…”

mentioning

confidence: 99%

Upper Extremity Deep Vein Thrombosis (Paget –Von Schroetter Syndrome) - A Rare Case Report

Bhadana¹

2017

JMSCR

View full text Add to dashboard Cite

show abstract

“…[4][5][6][9][10][11][12][13][14][15][16][17][18][19][20][21][22] The most common presentation is acute swelling of the dominant extremity; antecedent trauma or repetitive overhead activity has occasionally occurred. 5,6,16 Early recognition and aggressive treatment of this disorder has been recommended to avoid the long-term sequelae associated with chronic venous obstruction. 12,16,23 Most reports of effort thrombosis associated with sport participation document occurrence of this disorder in the dominant extremity of overhead throwing athletes.…”

mentioning

confidence: 99%

“…5,6,16 Early recognition and aggressive treatment of this disorder has been recommended to avoid the long-term sequelae associated with chronic venous obstruction. 12,16,23 Most reports of effort thrombosis associated with sport participation document occurrence of this disorder in the dominant extremity of overhead throwing athletes. 16 Furthermore, several authors 6,24 recommended thrombolytic therapy and surgical decompression in the young active population.…”

mentioning

confidence: 99%

“…12,16,23 Most reports of effort thrombosis associated with sport participation document occurrence of this disorder in the dominant extremity of overhead throwing athletes. 16 Furthermore, several authors 6,24 recommended thrombolytic therapy and surgical decompression in the young active population. We present a unique treatment regimen for effort thrombosis in the nondominant extremity of a nonthrowing athlete who was successfully treated acutely with anticoagulation therapy alone.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Unique Treatment Regimen for Effort Thrombosis in the Nondominant Extremity of an Overhead Athlete: A Case Report

Snead

Marberry

Rowdon

2009

Journal of Athletic Training

View full text Add to dashboard Cite

Objective: To advise athletic trainers on the potential for effort thrombosis to occur in nonthrowing athletes and to underscore the importance of early recognition and treatment. Background: An 18-year-old offensive lineman presented with a 1-day history of diffuse shoulder pain with no specific history of injury; swelling and erythema involved the entire left upper extremity. He was immediately referred to the team physician, who suspected deep vein thrombosis and sent the athlete to an imaging center. Duplex ultrasound was obtained on the day of presentation, and he was admitted to the hospital that evening. Differential Diagnosis: Deep vein thrombosis, thoracic outlet syndrome, shoulder tendinitis. Treatment: Anticoagulation with heparin was administered at the hospital, and he was sent home the next day on subcutaneous enoxaparin sodium, followed by a 5-mg daily dose of oral warfarin sodium. Oral anticoagulants were continued for a total of 4 weeks. The athlete began upper body lifting and was released 5 weeks postinjury to gradually return to football without restrictions. Uniqueness: Effort thrombosis is typically seen in the dominant arm of athletes, and the current treatment protocol calls for thrombolysis or surgical intervention. This athlete, whose position required repeated elevation of his arms in forward flexion, sustained the injury in his nondominant arm, was treated with anticoagulation only, and had a full return to football. At 18-month follow-up, he had no recurrence of symptoms. Conclusions: Early recognition and treatment of athletes with effort thrombosis is paramount to a successful clinical outcome and prompt return to play.

show abstract

Effort Thrombosis in the Elite Throwing Athlete

Abstract: Prompt clinical recognition, diagnosis, and treatment of effort thrombosis in the elite baseball player provides the player with an excellent prognosis for return to the previous level of play.

Cited by 56 publications

References 34 publications

Case Reports: Unusual Cause of Shoulder Pain in a Collegiate Baseball Player

Case Reports: Unusual Cause of Shoulder Pain in a Collegiate Baseball Player

Upper Extremity Deep Vein Thrombosis (Paget –Von Schroetter Syndrome) - A Rare Case Report

Unique Treatment Regimen for Effort Thrombosis in the Nondominant Extremity of an Overhead Athlete: A Case Report

Contact Info

Product

Resources

About