Shoulder pain in baseball players

The biomechanical features of baseball pitching are illustrated and an account is given of 23 painful throwing arm shoulders revealed during the clinical screening (anamnesis, objective examination, passive tests and active tests against resistance) of 92 professional pitchers. Radiography and comparative echography were also performed in these 23 cases, and MRI to rule out associated lesions was undertaken in 3 cases of subacromial impingement. Eighteen cases of primary tendon disorder and five cases of subacromial impingement were detected. Treatment consisted of CO2 laser therapy, rotator cuff stretching and strengthening the muscles centring the humeral head and stabilising the shoulder with extenders and weights, plus selective isokinetic strengthening in the management of subacromial impingement. Physical rehabilitation therapy secured the resumption of sport and lasting results. Stress is laid on the fact that selective strengthening of the rotator cuff secures regression of the disorders observed, early resumption of sport and freedom from relapses.