Skip to main content
SpringerLink
Log in

Principles of Surgical Evaluation and Techniques for the Shoulder in the Overhead Athlete

  • Chapter
  • First Online:
Mechanics, Pathomechanics and Injury in the Overhead Athlete

  • 675 Accesses

Abstract

Surgical treatment of the overhead athlete’s shoulder requires an in-depth knowledge of the pathologic processes of internal impingement in order to optimize treatment outcomes in patients who have failed conservative treatment. Overhead athletes have a predictable pattern of injury that includes superior labrum anterior-posterior (SLAP) tears, rotator cuff tears, anterior-inferior capsular laxity, and posterior-inferior capsular contracture. The purpose of this chapter is to highlight the principles and techniques of surgical treatment of the overhead athlete’s shoulder.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Uncategorized References

  1. Van Kleunen JP, et al. Return to high-level throwing after combination infraspinatus repair, SLAP repair, and release of glenohumeral internal rotation deficit. Am J Sports Med. 2012;40(11):2536–41.

    Article  Google Scholar 

  2. Andrews JR, Carson WG Jr, Mcleod WD. Glenoid labrum tears related to the long head of the biceps. Am J Sports Med. 1985;13(5):337–41.

    Article  CAS  Google Scholar 

  3. Burkhart SS, Morgan C. SLAP lesions in the overhead athlete. Orthoped Clin. 2001;32(3):431–41.

    Article  CAS  Google Scholar 

  4. Burkhart SS, Morgan CD, Kibler WB. Shoulder injuries in overhead athletes: the “dead arm” revisited. Clin Sports Med. 2000;19(1):125–58.

    Article  CAS  Google Scholar 

  5. Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology part I: Pathoanatomy and biomechanics. Arthroscopy. 2003;19(4):404–20.

    Article  Google Scholar 

  6. Heyworth BE, Williams RJ. Internal impingement of the shoulder. Am J Sports Med. 2009;37(5):1024–37.

    Article  Google Scholar 

  7. Jobe CM. Posterior superior glenoid impingement: expanded spectrum. Arthroscopy. 1995;11(5):530–6.

    Article  CAS  Google Scholar 

  8. Walch G, et al. Impingement of the deep surface of the supraspinatus tendon on the posterosuperior glenoid rim: an arthroscopic study. J Shoulder Elb Surg. 1992;1(5):238–45.

    Article  CAS  Google Scholar 

  9. Braun S, Kokmeyer D, Millett PJ. Shoulder injuries in the throwing athlete. J Bone Joint Surg. 2009;91(4):966–78.

    Article  Google Scholar 

  10. Burkhart SS, Lo IKY. The cam effect of the proximal humerus: its role in the production of relative capsular redundancy of the shoulder. Arthroscopy. 2007;23(3):241–6.

    Article  Google Scholar 

  11. Kibler WB, et al. The disabled throwing shoulder: spectrum of pathology; 10-year update. Arthroscopy. 2013;29(1):141–161.e26.

    Article  Google Scholar 

  12. Burkhart SS, Morgan CD. The peel-back mechanism: its role in producing and extending posterior type II SLAP lesions and its effect on SLAP repair rehabilitation. Arthroscopy. 1998;14(6):637–40.

    Article  CAS  Google Scholar 

  13. Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology Part II: Evaluation and treatment of SLAP lesions in throwers. Arthroscopy. 2003;19(5):531–9.

    Article  Google Scholar 

  14. Andrews JR, Broussard TS, Carson WG. Arthroscopy of the shoulder in the management of partial tears of the rotator cuff: a preliminary report. Arthroscopy. 1985;1(2):117–22.

    Article  CAS  Google Scholar 

  15. Snyder SJ, et al. SLAP lesions of the shoulder. Arthroscopy. 1990;6(4):274–9.

    Article  CAS  Google Scholar 

  16. Jobe FW, et al. Anterior capsulolabral reconstruction of the shoulder in athletes in overhand sports. Am J Sports Med. 1991;19(5):428–34.

    Article  CAS  Google Scholar 

  17. Morgan CD, et al. Type II SLAP lesions: three subtypes and their relationships to superior instability and rotator cuff tears. Arthroscopy. 1998;14(6):553–65.

    Article  CAS  Google Scholar 

  18. Stodden DF, et al. Relationship of biomechanical factors to baseball pitching velocity: within pitcher variation. J Appl Biomech. 2005;21(1):44–56.

    Article  Google Scholar 

  19. Bigliani LU, et al. Shoulder motion and laxity in the professional baseball player. Am J Sports Med. 1997;25(5):609–13.

    Article  CAS  Google Scholar 

  20. Reagan K, et al. Humeral retroversion and its relationship to glenohumeral rotation in the shoulder of college baseball players. Am J Sports Med. 2002;30(3):354–60.

    Article  CAS  Google Scholar 

  21. Kuhn JE, et al. Ligamentous restraints to external rotation of the humerus in the late-cocking phase of throwing: a cadaveric biomechanical investigation. Am J Sports Med. 2000;28(2):200–5.

    Article  CAS  Google Scholar 

  22. Fitzpatrick MJ, et al. Development of cadaveric models of a thrower’s shoulder. J Shoulder Elb Surg. 2005;14(1):S49–57.

    Article  Google Scholar 

  23. Grossman MG, et al. A cadaveric model of the throwing shoulder: a possible etiology of superior labrum anterior-to-posterior lesions. J Bone Joint Surg. 2005;87(4):824–31.

    PubMed  Google Scholar 

  24. Fleisig GS, et al. Kinetics of baseball pitching with implications about injury mechanisms. Am J Sports Med. 1995;23(2):233–9.

    Article  CAS  Google Scholar 

  25. Kuhn JE, et al. Failure of the biceps superior labral complex: a cadaveric biomechanical investigation comparing the late cocking and early deceleration positions of throwing. Arthroscopy. 2003;19(4):373–9.

    Article  Google Scholar 

  26. Levitz CL, Dugas J, Andrews JR. The use of arthroscopic thermal capsulorrhaphy to treat internal impingement in baseball players. Arthroscopy. 2001;17(6):573–7.

    Article  CAS  Google Scholar 

  27. Hirashima M, et al. Sequential muscle activity and its functional role in the upper extremity and trunk during overarm throwing. J Sports Sci. 2002;20(4):301–10.

    Article  Google Scholar 

  28. Verna C. Shoulder flexibility to reduce impingement. In 3rd Annual Professional Baseball Athletic Trainers Society Meeting, 1991.

    Google Scholar 

  29. Boes MT, Morgan CD. Management of shoulder throwing injuries. Operative techniques in sports medicine surg, 2011, p. 38.

    Google Scholar 

  30. Caldwell PE III, Dyer DC, Pearson SE. Arthroscopic debridement of the thrower’s shoulder: less is more. Arthrosc Tech. 2016;5(6):e1381–6.

    Article  Google Scholar 

  31. Davidson PA, et al. Rotator cuff and posterior-superior glenoid labrum injury associated with increased glenohumeral motion: a new site of impingement. J Shoulder Elb Surg. 1995;4(5):384–90.

    Article  CAS  Google Scholar 

  32. Samani JE, Marston SB, Buss DD. Arthroscopic stabilization of type II SLAP lesions using an absorbable tack. Arthroscopy. 2001;17(1):19–24.

    Article  CAS  Google Scholar 

  33. Pagnani MJ, et al. Arthroscopic fixation of superior labral lesions using a biodegradable implant: a preliminary report. Arthroscopy. 1995;11(2):194–8.

    Article  CAS  Google Scholar 

  34. Mazoué CG, Andrews JR. Repair of full-thickness rotator cuff tears in professional baseball players. Am J Sports Med. 2006;34(2):182–9.

    Article  Google Scholar 

  35. Conway JE. Arthroscopic repair of partial-thickness rotator cuff tears and SLAP lesions in professional baseball players. Orthoped Clin. 2001;32(3):443–56.

    Article  CAS  Google Scholar 

  36. Wright RW, Paletta GA. Prevalence of the Bennett lesion of the shoulder in major league pitchers. Am J Sports Med. 2004;32(1):121–4.

    Article  Google Scholar 

  37. Wright RW, Steger-May K, Klein SE. Radiographic findings in the shoulder and elbow of Major League Baseball pitchers. Am J Sports Med. 2007;35(11):1839–43.

    Article  Google Scholar 

  38. Ozaki J, et al. Surgical treatment for posterior ossifications of the glenoid in baseball players. J Shoulder Elb Surg. 1992;1(2):91–7.

    Article  CAS  Google Scholar 

  39. Bennett GE. Elbow and shoulder lesions of baseball players. Am J Surg. 1959;98(3):484–92.

    Article  CAS  Google Scholar 

  40. Ferrari JD, et al. Posterior ossification of the shoulder: the Bennett lesion: etiology, diagnosis, and treatment. Am J Sports Med. 1994;22(2):171–6.

    Article  CAS  Google Scholar 

  41. Chandnani VP, et al. Glenohumeral ligaments and shoulder capsular mechanism: evaluation with MR arthrography. Radiology. 1995;196(1):27–32.

    Article  CAS  Google Scholar 

  42. Chandnani V, et al. Glenoid labral tears: prospective evaluation with MRI imaging, MR arthrography, and CT arthrography. AJR Am J Roentgenol. 1993;161(6):1229–35.

    Article  CAS  Google Scholar 

  43. Palmer WE, Brown JH, Rosenthal DI. Labral-ligamentous complex of the shoulder: evaluation with MR arthrography. Radiology. 1994;190(3):645–51.

    Article  CAS  Google Scholar 

  44. Palmer W, Caslowitz P, Chew F. MR arthrography of the shoulder: normal intraarticular structures and common abnormalities. AJR Am J Roentgenol. 1995;164(1):141–6.

    Article  CAS  Google Scholar 

  45. Tirman P, et al. Posterosuperior glenoid impingement of the shoulder: findings at MR imaging and MR arthrography with arthroscopic correlation. Radiology. 1994;193(2):431–6.

    Article  CAS  Google Scholar 

  46. Halbrecht JL, Tirman P, Atkin D. Internal impingement of the shoulder: comparison of findings between the throwing and nonthrowing shoulders of college baseball players. Arthroscopy. 1999;15(3):253–8.

    Article  CAS  Google Scholar 

  47. Burkhart SS, Lo IK, Brady PC. Burkhart’s view of the shoulder: a cowboy’s guide to advanced shoulder arthroscopy. Philadelphia: Lippincott Williams & Wilkins; 2006. p. 307–8.

    Google Scholar 

  48. Dines JS, ElAttrache NS. Horizontal mattress with a knotless anchor to better recreate the normal superior labrum anatomy. Arthroscopy. 2008;24(12):1422–5.

    Article  Google Scholar 

  49. Meister K, et al. Symptomatic thrower’s exostosis. Am J Sports Med. 1999;27(2):133–6.

    Article  CAS  Google Scholar 

  50. Riand N, Boulahia A, Walch G. Posterosuperior impingement of the shoulder in the athlete: results of arthroscopic debridement in 75 patients. Rev Chir Orthop Reparatrice Appar Mot. 2002;88(1):19–27.

    CAS  PubMed  Google Scholar 

  51. Liem D, et al. Arthroscopic rotator cuff repair in overhead-throwing athletes. Am J Sports Med. 2008;36(7):1317–22.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Tulane University Department of Orthopaedics, New Orleans, LA, USA

    Geoffrey P. Stone & Felix H. Savoie III

Authors
  1. Geoffrey P. Stone
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Felix H. Savoie III
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Felix H. Savoie III .

Editor information

Editors and Affiliations

  1. Shoulder Center of Kentucky, Lexington Clinic, Lexington, KY, USA

    W. Ben Kibler

  2. Eastern Kentucky University, Richmond, KY, USA

    Aaron D. Sciascia

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Stone, G.P., Savoie, F.H. (2019). Principles of Surgical Evaluation and Techniques for the Shoulder in the Overhead Athlete. In: Kibler, W., Sciascia, A. (eds) Mechanics, Pathomechanics and Injury in the Overhead Athlete. Springer, Cham. https://doi.org/10.1007/978-3-030-12775-6_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-12775-6_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-12774-9

  • Online ISBN: 978-3-030-12775-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation