Slap lesions in pitchers

Morton’s Neuroma Prolotherapy

In this article Ross Hauser, MD. will discuss research concerning return to play in major league baseball pitchers undergoing surgical and non-surgical repair for SLAP lesions.

Doctors at Houston Methodist Hospital published these findings in the American Journal of Sports Medicine:

The published return-to-play (RTP) rates for athletes who have undergone surgical repair of superior labrum anterior-posterior (SLAP) tears vary widely and are generally accepted to be lower in the group of competitive throwers (baseball pitchers). Therefore the effectiveness of nonsurgical treatment should be explored.

Prolotherapy Shoulder ExamThe Houston group looked at 119 patients in a single professional baseball organization with persistent shoulder pain that limited the ability to compete.

Those who failed 2 cycles of nonsurgical treatment were treated surgically.

Success was defined by 2 different standards:

(1) return-to-play (RTP), success was measured in accordance with previous study findings; and
(2) a more stringent standard of return to the same level/quality of professional competition (level A baseball, Double A baseball, Triple A baseball etc.) with the incorporation of a return to preinjury individual performance statistics (earned run average, walks plus hits per inning pitched), termed “return to prior performance” (RPP).


Non-surgical injection therapy for SLAP lesions

In a study from late 2016, doctors at Wayne State University School of Medicine published these findings:

However, the overall rate of return to prior performance, including those unable to return-to-play rate, was 54.2%. A little more than half had a successful surgery and return to prior performance. However  performance analysis of the return-to-play group revealed a statistically significant decrease in innings pitched for Major League pitchers throwing a mean 101.8 innings before injury and 65.53 innings after injury.2

For a more detailed discussion of SLAP lesion surgery, you can continue on to our article SLAP Tears and alternative treatments. For more information on Prolotherapy for shoulder pain.

If you would like to discuss non-surgical options for your SLAP lesion problems – talk to our specialists. 

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1 Fedoriw WW, Ramkumar P, McCulloch PC, Lintner DM. Return to play after treatment of superior labral tears in professional baseball players. Am J Sports Med. 2014 May;42(5):1155-60. [Pubmed]

2 Smith R, Lombardo DJ, Petersen-Fitts GR, et al. Return to Play and Prior Performance in Major League Baseball Pitchers After Repair of Superior Labral Anterior-Posterior Tears. Orthopaedic Journal of Sports Medicine.  2016;4(12):2325967116675822. [Pubmed]

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