Study Examines Injury Return Rate

In a study released on Saturday of 44 professional baseball players, researchers found that only 45 percent of the players "were able to return to the game at the same or higher level after shoulder or elbow surgery." Of the 44 players studied, 35 were pitchers. One noteworthy finding that is consistent with previous research was that players returning from shoulder surgery were less likely to return at the same or higher playing level than those who had elbow surgery.

"In an ideal world, of course, we would get 100 percent of the players back to their pre-injury level or higher," says Steven B. Cohen, MD, assistant team physician for the Philadelphia Phillies and director of Sports Medicine Research at the Rothman Institute in Philadelphia. "But the fact of the matter is at this elite level of the sport, the physical demands of throwing have much higher requirements than the regular person on the street. The average person who has shoulder or elbow surgery can return to their regular activities. Throwing a baseball at the professional level puts a significant amount of stress on the shoulder and the elbow."

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"As a surgeon, obviously these statistics were disappointing and somewhat lower than what we would like them to be," said Cohen. "This may give us cause, however, to look at how we evaluate and treat these injuries to the throwing arm. Our goal is to get these elite athletes back to their premier pre-injury health. This is important both to the player who is making a living off his athletic ability and the organization that wants its players in top shape. We may need to examine if there is a way to ‘fine-tune’ these procedures to customize them for the demands of a professional baseball player."

Four years ago, BA’s John Manuel took an in-depth look at why shoulder injuries often cause more damage to a player’s career than an elbow injury would.

"The shoulder is so complicated because it’s a multidirectional joint, and the more doctors and trainers get into the shoulder, more is learned," (Mariners trainer Mickey Clarizio) says. "You have the elbow, which is a hinge joint, and now we have a procedure like Tommy John surgery that has a good case history going. With the shoulder, the surgical techniques are great, but we’re not seeing the returns we’d hope to see. We don’t have a Tommy John procedure for the shoulder.

"If you’re having surgery, in essence your career is over. You’re having surgery to be able to throw again. And just because you’re having it does not mean you will come back. You’re only having it because your goal is to pitch in the major leagues, and if your shoulder is hurt, you can’t get anyone out.

One reason that the health history of amatuer and minor league players is so crucial for scouts and player development officials to consider is that those players are in developmental phases of their careers. While the advances in medical technology have led to procedures such as Tommy John surgery that allow a pitcher to come back after a year off, that pitcher has still missed a year of time to develop his command, streamline his mechanics (which may have been off in the first place to lead to the injury, thus leaving him vulnerable to further injury) and gain experience facing professional hitters. Couple that loss of developmental time and increased injury risk with a potential decrease in pitch quality due to the injuries, and the health history of a young player can be a key determinant in his future success.