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Conservative care of SLAP tears in baseball players may increase odds of return to play

BALTIMORE – Nonsurgical treatment of scapular dyskinesia and glenohumeral internal rotation deficits had a higher success rate than surgical repair for professional baseball players with painful shoulders and SLAP lesions.

“Nonsurgical treatment for SLAP lesions in professional baseball players can result in a high rate of return to previous performance,” Wasyk W. Fedoriw, MD, said at the American Orthopaedic Society for Sports Medicine Annual Meeting 2012 here.

The researchers performed a retrospective review of 119 baseball players who had persistent shoulder pain that limited their ability to compete within a single professional baseball organization. Sixty-eight players had MRI-documented SLAP lesions and failed initial rehabilitation. All patients were initially treated nonsurgically according to an algorithm focused on correcting the scapular dyskinesia and posterior capsular contracture with internal rotation loss followed by pain-free return to throwing. Success was defined by previous studies as return to competition, and with a second more stringent standard of incorporating return to the same level of competition and performance statistics.

Of the 68 athletes with documented SLAP lesions, 45 were pitchers and 23 were position players. Twenty-three pitchers successfully completed the nonsurgical algorithm and attempted return. The return-to-play (RTP) rate was 87%, and RTP to the same level of competition was 65%. The RTP for 26 surgically treated pitchers was 46%, and the RTP at the same level of competition was 12%.

For eight position players who received nonsurgical treatment, RTP was 100% with RTP at the same level of 75%. The RTP for 15 position players treated with surgery (17 procedures) was 71%, with RTP at same level of 35%.

“After a SLAP tear, most professional baseball athletes return to play. However, many position players and most pitchers never return to their previous level of performance in playing their sport,” Fedoriw said.

Reference:

Fedoriw WW, Ramkumar P, Lintner DM. Nonsurgical and surgical treatment of superior labral tears in professional baseball players. Paper #6. Presented at the American Orthopaedic Society for Sports Medicine Annual Meeting 2012. July 12-15. Baltimore.

Disclosure: Fedoriw has no relevant financial disclosures.