Comeback to a pre-injury level disappointing for professional baseball players

Only 45 percent of baseball players were able to return to the game at the same or higher level after shoulder or elbow surgery, according to new research released during the 2008 American Orthopaedic Society for Sports Medicine Specialty Day at The Moscone Center.

“In an ideal world, of course, we would get 100 percent of the players back to their pre-injury level or higher,” says Steven B. Cohen, MD, assistant team physician for the Philadelphia Phillies and director of Sports Medicine Research at the Rothman Institute in Philadelphia. “But the fact of the matter is at this elite level of the sport, the physical demands of throwing have much higher requirements than the regular person on the street. The average person who has shoulder or elbow surgery can return to their regular activities. Throwing a baseball at the professional level puts a significant amount of stress on the shoulder and the elbow.”

Over a four-season period, Cohen and colleagues studied 44 players from one professional baseball club (major league, AAA, AA and A) who underwent 50 shoulder and elbow operations by a variety of surgeons. There were 27 shoulder surgeries performed on 26 players and 23 elbow surgeries performed on 21 players. A key finding of the study was that players returning after elbow surgery were more likely to comeback to the same or higher playing level than those who had shoulder surgery. Thirty-five of the players were pitchers with 43 percent returning to the same or higher playing level.

The researchers found that overall, only 20 of the 44 players (45 percent) returned to the same or higher level of professional baseball. For ballplayers at the major league, AAA, or AA level, the study found only 4 of 22 (18 percent) were able to return to the same or higher level.

“As a surgeon, obviously these statistics were disappointing and somewhat lower than what we would like them to be,” said Cohen. “This may give us cause, however, to look at how we evaluate and treat these injuries to the throwing arm. Our goal is to get these elite athletes back to their premier pre-injury health. This is important both to the player who is making a living off his athletic ability and the organization that wants its players in top shape. We may need to examine if there is a way to ‘fine-tune' these procedures to customize them for the demands of a professional baseball player.”