Therapy Tops Surgery for SLAP Tears

Surgically repairing a shoulder injury in baseball players may not be the best medical decision. Researchers who presented their findings at the American Orthopaedic Society for Sports Medicine’s Annual Meeting in Baltimore, Maryland, suggest that nonsurgical treatment of what are called SLAP (superior labral) tears may be more beneficial.

“Our research showed that nonsurgical treatment of SLAP tears was often more successful than surgery, and in position players more frequently than for pitchers, ” said David Lintner, M.D., lead researcher from Methodist Center for Sports Medicine in Houston, Texas, in the July 12 news release. “We need more research to determine why the nonsurgical treatment was more beneficial to one population than the other, but our findings did illustrate that nonsurgical treatment should be preferred, ” he said.

Lintner and his team performed a retrospective review of a 119 professional baseball players within a single organization who had persistent shoulder pain that limited their ability to compete. Sixty-eight of the patients had MRI-documented SLAP lesions and had failed initial physical therapy. All patients were initially treated non-surgically according to an algorithm focused on correcting the scapular dyskinesia and posterior capsular tightness. Of the 68 subjects with confirmed SLAP lesions, 45 were pitchers. Return to competition appeared to occur at a higher rate for position players than it did for pitchers (73% vs. 40%).

“Returning to the same level of competition as before the injury, is almost always difficult for an athlete, and surgery is often thought of as the best avenue. With additional research, orthopaedists are finding different routes to treat some of the most common throwing injuries, ” said Lintner.