Baseball pitchers are exposed to extremes of stress, imposed in throwing a ball at speeds over 100 km per hour. These movements subject a number of anatomical regions to repetitive motion type injuries, including the shoulder, elbow, cervical and thoracolumbar spine. As might be anticipated, the most common and most serious injuries sustained by pitchers involve the shoulder joint. The reasons for this are quite obvious. From an anatomical perspective, the shoulder joint and the surrounding tissues are structurally complex, highly mobile and involved in most upper body movements.
Initially, the pitcher complains of pain and subsequently undergoes examination and treatment by the trainer. Ultrasound studies, X-rays, MRIs and PET Scans follow, often on an all too frequent basis and clearly without any significant clinical benefit. Therapy almost invariably consists of a combination of treatments designed to alleviate the symptoms. These include exercise, interferential current, ultrasound, massage and the inevitable application of ice.
Essentially, ice is a counter-irritant and is not beneficial with regard to cellular function or structure. It should be noted that these therapies modulate symptoms in contradistinction to Laser Therapy which is designed to heal tissue at the cellular level, thereby restoring normal cell structure and function. In essence, this technology cures the existing pathology and thereby achieves the desired result.
Generally, conventional therapies relieve symptoms temporarily and as the inflammation subsides, the pitcher resumes throwing. In my experience, rest, gentle stretching and the application of some heat accomplishes the same objective, probably more rapidly. Subsequent to the institution of modulation therapies, pitchers undergo a course of rehabilitation, primarily based on exercise, which may be counter-productive with regard to the healing process.
The institution of surgery following unsuccessful rehabilitation almost invariably results in permanent failure. For surgical repair to be successful, at least from a theoretical perspective, complete immobilization of the shoulder for six weeks or more would be required. This measure is seldom observed, therefore the repair is subject to technical breakdown.
At Meditech, we feel a more rational and elegant therapy would be to adopt the following strategy:
• Rest (during early phase of injury)
• The administration of Laser Therapy daily
• Massage as indicated
• The initiation of gentle stretching 1-2 weeks post injury
The incorporation of this relatively simple approach to all shoulder injuries sustained by baseball pitchers would lead to a cure in over 90% of all cases; a player’s career would therefore be extended. For example Duane Ward and a host of other pitchers that have labored for the Toronto Blue Jays and other baseball organizations in the past, are prime examples of the results produced utilizing the surgical approach for shoulder injuries. All too frequently, subsequent to surgery, pitchers will seldom throw the ball again – certainly not at the professional level.
Combining the healing potential of laser, nature (i.e. time) and other conservative measures, over 90% of all pitchers post injury could be returned to a normal functional levels, if the Meditech strategy is followed.
Fred Kahn, MD, FRCS(C)