Houston Methodist. Leading Medicine

Shoulder FAQ

Question:

I can't really say too much and please do not release my name but I am a professional pitcher with a major league baseball team and a serious shoulder problem. I have both a rotator cuff tear and a labral tear. It kills me to pitch but it is my life. However, my pitching accuracy is so off and my speed is so slow, I have no choice but to try surgery. How long would it take to recover from something like this?

Answer:

There are many different reasons why elite baseball pitchers may need shoulder surgery. But the biggest question is always, How long will it be before I can go back to pitching? Some answers can be found in a recent research report from the Division of Sports Medicine (Department of Orthopedic Surgery) at Rush Medical College in Chicago, Illinois. Surgeons there searched several electronic data sources for studies that might address this question. They found six that qualified with a total of 287 elite pitchers. All were men, most were professional athletes, and all had reparative or reconstructive shoulder surgery. Almost all of the pitchers (99 per cent) injured their dominant (pitching) arm. And many (like yourself) had more than one shoulder injury requiring surgical correction. Injuries included rotator cuff tears, impingement, joint laxity, joint degeneration, labral tears, and internal impingement. The authors were interested in establishing the rate of return to sports participation among these elite baseball pitchers after surgery. They found that 68 per cent of the players were able to get back into action (pitching competitively) approximately 12 months after surgery. Some players were able to return to pitching within nine months after the surgery. Others were not ready for a year and a half (18 months). Very few actually made it back to sports participation the same year they had the surgery. This was especially true for those who had rotator cuff or labral surgery. If 68 per cent were able to return to pitching, what happened to the other pitchers? Twenty-two per cent (22%) never made it back and ended up retiring from professional baseball. Those who returned to pitching reported some noticeable differences from before their injuries. For example, they pitched far fewer innings post-operatively compared with pre-injury. Certainly, the successful group was able to pitch more than they could after the injury or just prior to surgery. What was important to the players was pitch accuracy, speed, and endurance. Follow-up over the next three and a half years showed a gradual, continued improvement in all areas of performance (e.g., strikeouts, walks, hits per inning pitched). Complaints reported by pitchers included early fatigue (compared to pre-injury status) and a sense of loss over pitch control. Measurements taken did show a slight decline in maximum pitch velocity (from 94.2 miles per hour to 90.1 miles per hour). Pitching at the professional level requires a fine balance between movement (mobility) and stability. With only slightly more than two-thirds of the pitchers returning to play following shoulder surgery (and very few during the same season), every effort to rehab with a conservative approach is advised. But since this is no longer an option for you, be aware that surgery may not result in a full return-to-play. And if you are able to return to pitching, you may not reach pre-injury levels of pitching. Your surgeon is the best one to advise you directly based on the specific details of your injuries and your situation. Be sure and ask for whatever recommendations and guidelines he or she may have for you and good luck! Joshua D. Harris, MD, et al. Return to Sport Following Shoulder Surgery in the Elite Pitcher: A Systematic Review. In Sports Health. July/August 2013. Vol. 5. No. 4. Pp. 367-376.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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