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Unique Injuries in Baseball

Baseball lends itself to some unique injuries and over the last 28 seasons of professional baseball in South Bend, I’ve seen many interesting things caring for our players.

As in other sports involving rapid starts and stops, lateral movement and collisions, injuries to knee ligaments such as the anterior cruciate ligament aren’t uncommon. With awkward stops or turns, baseball players can rupture their patellar or Achilles tendons. But the most common lower extremity injury that puts a player on the disabled list for an extended period of time is the hamstring strain. This injury occurs when the player reaches for that extra gear as they try to stretch for the extra base or run down a fly ball in the outfield. Fortunately, treatment is usually nonoperative but players very rarely come back quickly.

The upper extremity of the body, which includes the shoulder, arm, forearm, wrist and hand, can often give us ligament injuries at the elbow. While the Tommy John surgery can reconstruct it by grafting a tendon from elsewhere in the body, it also yields shoulder problems such as damaged rotator cuffs and torn cartilage that can lead to the shoulder sliding part way out of joint.

While I’ve seen many cases of hamstring injuries over the years, the most interesting injury I’ve come across in the upper extremity involves the compromise of circulation in the arm. I’ve seen two cases of what is called “effort thrombosis” in which, as a result of strengthening the muscles at the base of the neck, the vein that carries the blood back out of the arm can clot off and impede the blood flow. The arm becomes swollen, congested, and discolored and the player complains of a vague sense of discomfort. If the artery rather than the vein is more damaged, the weakened walls can shed tiny blood clots down to the fingers, and while the arm won’t swell or discolor, the player may start losing sensation in the fingers. Unfortunately, treatment for these two circulatory disorders usually means a trip to the operating room for some combination of clot removal and vessel repair.

Think it’s macho to repeatedly catch your buddy while he throws to you as hard as he can? Unfortunately, catchers are usually subject to spasms in the small arteries in the fingers as a result of this repeated impact of catching the ball, and I’ve seen two catchers (and strangely, one second baseman) whose fingers turned white and whose catching hand went numb from spasm-induced lack of blood supply. Catchers are at the highest risk, and treatment usually is rest, medication to open the vessels, aspirin to keep clots from forming in these tiny vessels, and avoiding spasm-inducing substances such as nicotine. Usually when a player hears that he can lose his fingers if he continues smokeless tobacco use, he will stop fairly quickly.

As a fan, I’ve always been fascinated by baseball and its history, but as a doctor, I’m even more fascinated by the maladies so unique to this sport we all enjoy.

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