Deficiencies in pitching biomechanics after SLAP repair
SLAP repairs and the subsequent rehabilitation are aimed at restoring normal anatomy, allowing tissues to heal and protecting from recidives – this may on the other hand also cause limitations in ROM that lead to altered pitching biomechanics. This study confirmed that pitchers with a history of SLAP repair exhibit less horizontal abduction and external rotation and a more upright trunk position.
SLAP tears develop in pitchers as a result of repetitive overhead throwing – during which the glenohumeral joint is loaded at its end ranges and the labrum and the long head of the biceps tendon become compromised. An important objective of a SLAP repair and the following rehabilitation is to restore anatomy, allow tissues to heal, and to protect them refraining from activities that cause tensioning.
This, however, may also lead to decreases in ROM, having adverse effects on pitching biomechanics. In order to establish whether altered biomechanics are present after a SLAP repair, the current study retrospectively analysed kinematic and kinetic data on 13 pitchers with a history of SLAP repair and compared these with a control group of 52 pitchers with no history of surgery.
Pitchers with a history of SLAP repair exhibited less horizontal abduction and external rotation during overhead throwing. Although it was expected that elbow biomechanics would also be altered, this was not the case. The trunk position during throwing, on the other hand, was more upright in pitchers with a history of SLAP repair.
At what stage in the rehabilitation after shoulder surgery do you start with (passively or actively) loading the tissues again? Which factors play a role in this decision?
> From: Laughlin et al., Am J Sports Med 42 (2015) 2837-2841. All rights reserved to The Author(s). Click here for the Pubmed summary.