'Batter's shoulder': can athletes return to play at the same level after operative treatment?

BACKGROUND

Batter's shoulder has been defined as posterior subluxation of the lead shoulder during the baseball swing. However, it is unclear whether or how frequently patients may return to play after treatment of this uncommon condition.

QUESTIONS/PURPOSES: We therefore determined the rate of return to play after operative treatment for Batter's shoulder and whether ROM was restored.

METHODS

We retrospectively reviewed the records of 14 baseball players diagnosed with Batter's shoulder. Four played professionally, six were in college, and four were in varsity high school. The average age was 20.3 years (range, 16-33 years). All had physical examinations and MRI findings consistent with posterior labral tears involving the lead shoulder. Treatment involved arthroscopic posterior labral repair (n = 10), débridement (n = 2), or rehabilitation (n = 2). The minimum followup was 18 months (average, 2.8 years; range, 18-64 months).

RESULTS

Eleven of 12 surgically treated patients returned to their previous level of batting at an average of 5.9 months after surgery. The one patient who was unable to return to play also had an osteochondral lesion of the glenoid identified at surgery. Players typically returned to hitting off a tee at 3 months and to facing live pitching at 6 months postoperatively. All patients regained full internal and external ROM as compared with preoperative data.

CONCLUSIONS

Batter's shoulder is an uncommon form of posterior instability in hitters affecting their lead shoulder. Most athletes are able to return to play at the same level after arthroscopic treatment of posterior capsulolabral lesions.

LEVEL OF EVIDENCE

Level IV, case series. See Guidelines for Authors for a complete description of levels of evidence.