Injuries in Overhead Athletes: Editorial Comment

Abstract

While baseball has been played for more than 100 years, it was not until the middle of the 20th century that Dr. Bennett began writing about the unique injuries experienced by these athletes [2–4]. (In this issue, we have republished Bennett’s article from 1947 [10.1007/s11999-012-2335-2], and in 2008, we republished his article from 1959 [5].) In the 1970s and 1980s, Drs. Frank Jobe [6–8] and James Andrews [1, 9] began to specialize in the treatment of throwers and dedicated a substantial amount of time to improving the understanding of the mechanics of throwing and how those mechanics translated to the classic injuries seen. Elbow ulnar collateral ligament injuries, which at one time were career ending for pitchers, are now treated with surgical reconstruction that gets athletes back to their previous level of play more than 80% of the time [10]. The lay media suggest more than 10% of current major league baseball players have undergone ulnar collateral ligament reconstruction. The same can be said about superior labral anterior-posterior lesions, which are now treated relatively easily with arthroscopic repair. More recently, with improvements in biomechanical testing and imaging, and with the use of arthroscopy, we have been better able to classify the adaptive and pathologic findings unique to throwers. To that end, we have organized a symposium to summarize some of the current thinking as it pertains to the treatment of these athletes. The reader will see injuries to baseball players are no longer limited to the shoulder and elbow. Treating these athletes appropriately hinges on knowing what is considered a normal adaptive response to throwing and being able to discern when these adaptations become pathologic. Successful treatment also depends on understanding that the forces experienced by the body during throwing activities are not just limited to the shoulder. Clearly, the hip, scapula, and elbow are intimately involved in throwing effectively and in dissipating the stresses generated during the throwing motion. While it has been said “baseball is America’s national pastime,” it has truly become a game played by athletes of all levels all over the world. To that end, treatment of the characteristic injuries experienced by baseball players is no longer limited to the United States. Doctors from places such as Europe and Asia are becoming thought leaders in this field, and this is represented in the articles chosen for this symposium. We believe this compilation represents much of the current thinking as it pertains to preventing, diagnosing, and treating injuries that affect overhead athletes. More importantly, we believe these studies will inspire conversation and debate and act as a stimulus for future investigations. Fig. 1 Dr. Joshua S. Dines is shown Fig. 2 Dr. David W. Altchek is shown.