Batter’s Shoulder: Clinical Outcomes and Return to Sport

Abstract

Background Batter's shoulder has been defined as an acute posterior subluxation of the lead shoulder during a baseball swing causing a traumatic tear of the posterior labrum. There are limited data correlating repair techniques with return-to-play information but none utilizing standardized outcome measures. The purpose of this study is to examine a case series of patients for postoperative return-to-play and obtain follow-up using standardized outcome measures. Methods We retrospectively identified 10 patients with a batter's shoulder injury. Patients were included if they met the criteria for batter's shoulder injury. We attempted contact via telephone to complete Western Ontario Shoulder Instability (WOSI) and Disability of Arm Shoulder and Hand (QuickDASH) evaluations. We successfully reached five of the patients. The minimum follow-up was one year and the maximum was 11 years. Results All five patients in our cohort were able to return to play at the previous level without limitation. Patients reported a very low percentage limitation on the WOSI and QuickDASH questionnaires and results are detailed further on. Range of motion (ROM) and strength were not affected. Conclusion Batter's shoulder is an infrequent cause of posterior labral tearing, leading to a painful swing that can limit sports activity. In our limited series, all patients treated with arthroscopic repair were able to return to play at the previous level, confirming a significantly improved prognosis for a batter's shoulder injury in contrast to return to play after other causes of posterior labral tears.

Batter's Shoulder: All-Knotless Posterior Labral Repair With Retensionable Anchors for Treatment of Batter’s Shoulder

“…Recent studies have shown, regardless of fixation technique, between 91% and 100% of athletes with a Batter’s Shoulder injury are able to return to their previous level of play following arthroscopic treatment with posterior labral fixation. 9 , 10 While these studies illustrate the benefits of arthroscopic fixation of a Batter’s Shoulder injury, they fail to identify the specifics of the techniques and fixation used. This technical note provides a reproducible method of arthroscopic fixation for this specific injury.…”

“…Knotted fixation has been the traditional method of fixation in arthroscopic labral repair. 10 There has been a shift toward knotless fixation for anterior labral tears due to less knot abrasion, but there is a lack of research looking at knotless repairs of Batter’s Shoulder. Research looking at biomechanics and clinical outcomes on anterior labral tears, could suggest there is a benefit in using knotless fixation for a Batter’s Shoulder injury.…”

Number of Months of Baseball in the Previous Year and Preseason Olecranon Tenderness: Risk Factors for Shoulder and Elbow Injuries in High-School Baseball Players

“…Batting may also contribute to injury. 24,25 Although less frequent than pitchers, position players still place considerable force on their arms. Position players also generally do not have a "pitch count" to track the number of throws to help prevent injury.…”

Management of common upper extremity injuries in throwing athletes: a critical review of current outcomes

“…In some cases, hitting can lead to posterior instability or batter's shoulder, which occurs as the adducted lead arm absorbs a posteriorly directed force during the swinging motion, resulting in posterior subluxation/dislocation with spontaneous reduction. 29 Diagnosis is difficult because patients often present with pain rather than gross instability (75% vs 3%). 28 On occasion players may be able to recount a specific, traumatic event that caused the symptoms, but many times this is non-specific.…”