Neurologic Injuries in Baseball Players

Treihaft, Marc M.

doi:10.1055/s-2000-9827

Cited by 26 publications

(15 citation statements)

References 44 publications

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“…Ranges of motion N eurologic structures are concentrated around the shoulder and abundant neural elements are identified within the subacromial bursa, rotator cuff tendon, biceps tendon and tendon sheath, and transverse humeral ligament (1). Neurologic injuries or neuropathy in the shoulder could result from nerve entrapment (2,3), trauma (4,5), excessive motion (6), and rotator cuff injuries (7)(8)(9). Therefore, neuropathic pain could occur in the patients with rotator cuff lesions.…”

Section: Patient Populationmentioning

confidence: 99%

Prevalence and Risk Factors of Neuropathic Pain in Patients with a Rotator Cuff Tear

2018

Pain Phys

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Background: Until now, few studies had investigated the neuropathic pain component in patients with a rotator cuff tear (RCT). Objectives: The aim of the study was to identify the neuropathic pain component in patients with RCT and to determine the factors correlated with neuropathic pain in patients with RCT. Study Design: Prospective, cohort, prognostic study. Setting: Study patients who required arthroscopic rotator cuff repair were analyzed in a hospital setting. Methods: We prospectively studied 101 patients who were less than 60 years old with fullthickness tears requiring arthroscopic rotator cuff repair and met the inclusion and exclusion criteria. Multiple regression analysis was performed to identify variables that independently affected neuropathic pain in patients with a RCT. We use Douleur neuropathique 4 questionnaire (DN4) to assess neuropathic pain, which was ≥ 4 points of the DN4 questionaire. The visual analog scale (VAS) for the most severe pain within 4 weeks before admission and mean pain level during the last 4 weeks were checked. The atrophy grades of the rotator cuff muscles were classified on magnetic resonance images according to the Goutallier classification. The size and medial retraction of the RCT were measured during arthroscopic repair for RCT. Results: Sixteen (15.8%) of the 101 patients had neuropathic pain according to the cutoff values on the DN4 questionnaire for diagnosing neuropathic pain. The neuropathic pain group had significantly higher prevalence of smoking (P = 0.042), more mean VAS during last 4 weeks (P = 0.008), larger cuff tear (P = 0.003), more medial retraction of cuff (P = 0.016), and severe fatty degeneration of rotator cuff muscles (supraspinatus, P < 0.001; subscapularis, P < 0.001; and infraspinatus, P = 0.003) than the nonneuropathic pain group. The multiple logistic regression analyses showed that more mean VAS during the last 4 weeks and tear size of a rotator cuff were independent of other factors for the neuropathic pain of the patients with a full-thickness RCT. Limitations: Small sample size is the first limitation of this study. Conclusions: The prevalence of neuropathic pain in patients with a full-thickness RCT requiring arthroscopic rotator cuff repair was 15.8 % according to the DN4 questionnaire. The neuropathic pain component was more relevant to the severity of pain and tear size in the patients with a full-thickness RCT. It is important to be aware of the existence of neuropathic pain when treating a patient presenting with pain due to a RCT because accompanying neuropathy with a RCT could have a worse effect on repair of a RCT. IRB approval and clinical trial registration number: CR-15-045 Key words: Shoulder, rotator cuff tear, arthroscopic rotator cuff repair, neuropathic pain

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Section: Patient Populationmentioning

confidence: 99%

Prevalence and Risk Factors of Neuropathic Pain in Patients with a Rotator Cuff Tear

2018

Pain Phys

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“…1,2,4,6,7,9–16 The muscle wasting of the infraspinatus muscle is typically secondary to an injury to the suprascapular nerve at the spinoglenoid notch. Injury to the nerve at this location is distal to its innervation of the supraspinatus muscle, and therefore patients develop isolated atrophy and weakness of the infraspinatus muscle 1,2,4–12,15–17 (Fig. 1).…”

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confidence: 99%

Infraspinatus Muscle Atrophy in Professional Baseball Players

Cummins¹,

Messer²,

Schäfer

2004

Am J Sports Med

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“…The majority of acute sportsrelated neurovascular injuries often are associated with contact sports and not necessarily overhead-throwing sports such as baseball [5,22,26,27,40,41]. More common causes of shoulder pain in overhead athletes include internal impingement, instability, superior labral damage, rotator cuff injury (partial or complete tears), bursitis, and impingement syndrome.…”

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

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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.

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Neurologic Injuries in Baseball Players

Cited by 26 publications

References 44 publications

Prevalence and Risk Factors of Neuropathic Pain in Patients with a Rotator Cuff Tear

Prevalence and Risk Factors of Neuropathic Pain in Patients with a Rotator Cuff Tear

Infraspinatus Muscle Atrophy in Professional Baseball Players

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

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