Thoracic Outlet Syndrome in a Competitive Baseball Player Secondary to the Anomalous Insertion of an Atrophic Pectoralis Minor Muscle

Simovitch, Ryan W.; Bal, George K.; Basamania, Carl J.

doi:10.1177/0363546505284386

Cited by 20 publications

(10 citation statements)

References 9 publications

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“…The inferior GH ligament is the primary restraint when the arm is abducted to approximately 90 degrees and maximally externally rotated, similar to the late cocking and acceleration phases of the throwing motion. Pectoralis minor tightness has been identified in various baseball players [28][29][30][31] and has been associated with several scapular dysfunctions, including decreased upward rotation. 26,27 However, future research is needed in this area to confirm this hypothesis.…”

Section: Discussionmentioning

confidence: 99%

Shoulder Adaptations Among Pitchers and Position Players Over the Course of a Competitive Baseball Season

Laudner

Lynall²,

Meister³

2013

Clinical Journal of Sport Medicine

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These results suggest that baseball position players develop more scapular upward rotation over the course of a competitive season than pitchers. This discrepancy may increase the pitchers' risk of injury and may partially explain their higher incidence of shoulder injury compared with position players. Therefore, pitchers may benefit from strengthening exercises and stretches aimed at increasing scapular upward rotation throughout the competitive baseball season.

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Section: Discussionmentioning

confidence: 99%

Shoulder Adaptations Among Pitchers and Position Players Over the Course of a Competitive Baseball Season

Laudner

Lynall²,

Meister³

2013

Clinical Journal of Sport Medicine

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“…13,14 Although the insertion of the pectoralis minor tendon on the coracoid process can also compress the second portion of the axillary artery, potentially contributing to this phenomenon, this is probably of little significance. 15,16 Repetitive positional compression of the distal axillary artery or its branches has been sporadically reported in baseball players and other competitive overhead athletes, with most cases described in conjunction with various upper extremity neurovascular conditions or rare arteriopathies (Table IV). Along with the present series, review of these reports indicates that there have been 46 cases described, including 28 (61%) with axillary artery pathology and 18 (39%) with lesions of the axillary artery branch vessels, with the majority (70%) occurring in baseball players.…”

Section: Discussionmentioning

confidence: 99%

Positional compression of the axillary artery causing upper extremity thrombosis and embolism in the elite overhead throwing athlete

Duwayri

Emery

Driskill

et al. 2011

Journal of Vascular Surgery

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Repetitive positional compression of the axillary artery can cause a spectrum of pathology in the overhead athlete, including focal intimal hyperplasia, aneurysm formation, segmental dissection, and branch vessel aneurysms. Prompt recognition of these rare lesions is crucial given their propensity toward thrombosis and distal embolism, with positional arteriography necessary for diagnosis. Full functional recovery can usually be anticipated within several months of surgical treatment, consisting of mobilization and segmental reconstruction of the diseased axillary artery or ligation/excision of branch aneurysms, as well as concomitant management of distal thromboembolism.

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“…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

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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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Thoracic Outlet Syndrome in a Competitive Baseball Player Secondary to the Anomalous Insertion of an Atrophic Pectoralis Minor Muscle

Cited by 20 publications

References 9 publications

Shoulder Adaptations Among Pitchers and Position Players Over the Course of a Competitive Baseball Season

Shoulder Adaptations Among Pitchers and Position Players Over the Course of a Competitive Baseball Season

Positional compression of the axillary artery causing upper extremity thrombosis and embolism in the elite overhead throwing athlete

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

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