The Injury Analyst

PIcture this scenario: A pitcher starts to feel some pain at his 75th pitch in his shoulder. Coach sees his grimace and understands that its time to relieve him. Next step is straight to the athletic trainer who ices him up and straight to the M.D. he goes. His doctor gives him some lighter news, "It's just some tendinitis in your shoulder. Get some rest and in a few days you should be ready to go". And he is. By next start. But now he starts to feel that pain at the 65th pitch. "What in the world is going on!" So back to the team doctor who tells him that a cortisone shot in the shoulder will take down the inflammation and he should be fine. And again, he is. For another few months. Until it happens again. That's when it's decided to undergo surgery.

Now this exact scenario might not happen the way I portrayed it, but the way injuries are treated is pretty accurate. We see pain and we figure that if a guy throws 100 pitches a game that he has to have pain due to overuse. But how come some pitchers can go way more inninings and throw way more pitches than others and stay off the DL with ease. Now a good reply would be "Maybe some pitchers throw harder and more subject to stress" and you would be valid in saying that. But im sure we could find 2 pitchers with the same makeup that throw just as hard, one completely fine and one injury riddled on the surgeon's waiting list.

What we don't factor in are two things: the pitcher's mechanics and what's going on not only in his shoulder but in his shoulder complex (including the shoulder blade), in his neck, and even in his upper back.

Everyday I see an itis. Bursitis. Tendonitis. But what's causing all the itis or inflammation? I couldn't say off the top of my head because im not looking at what's causing the tissue to be pulled or hit on just enough to become inflamed. 

But that's why an injury needs to be analyzed. As complex of human beings we are, we all move a different way. Some movements more conducive to a healthy shoulder and some destructive that could keep a player on the IR for years no matter how many surgeries or shots given.

I will try to elucidate some common shoulder problems but not just like a textbook. I will explain some common movements that I see as a clinician that could cause the imfamous itis. 

Stay tuned...