Tigers reliever Bobby Seay torn rotator cuff rehab or surgery?

[fazmedia]

Dr Tomaino
Todays news out of Detroit is the teams star pitcher Bobby Seay rotator cuff injury.
He chose physical therapy over surgery. What are your thoughts on this

"It's a serious injury," Seay said. "This is an injury that could very well end my career. But it's also injury that I could possibly rehabilitate myself through."

Seay said the injury was called a Grade 2 undersurface tear. It nearly qualified as a Grade 3 tear, which would be the most severe on the scale. It involves the supraspinatus and infraspinatus tendons. The hope for rehab is to strengthen the muscles and everything around the injury to take as much pressure off it as possible."


full article:
http://mlb.mlb.com/news/article.jsp?ymd=20100327&content_id=8965624&vkey=news_mlb&fext=.jsp&c_id=mlb

[mtomaino]

Pitchers are at risk for this injury because of the high loads experienced by the shoulder during the pitching motion----windup through follow through. Because of extraordinary "external rotation," which allows for velocity, and the stresses on the shoulder posterior capsule, the undersurface of the rotator cuff can experience impingement on the rim of the glenoid (the socket" as well as tensile overload.

One of the primary "preventative" measures that most baseball trainers "in the know" institute is a stretching regimen aimed at maintaing internal rotation. Simply put, the back of the shoulder---"the posterior capsule" can become very tight, and when there is a significant deficit between internal and external rotation, injury is more likely.

"Rehab" may work---and if not, off season arthroscopic debridement can always be considered. It's helpful in the meanwhile, for pitchers at all levels, to work on posterior capsular stretching exercises such as the "sleeper stretch."

A video of this stretch can be found on the shoulder page on www.drtomaino.com

[mtomaino]

There are no exercises to speed healing of the torn portion of you cuff, BUT a rehabilitation program aimed at the remaining cuff can indeed help you recover, without surgery potentially. This revolves around PT to improve scapulohumeral rhythm and cuff strength, as well as capsular stretching to minimize any internal rotation deficit.