AANA25 Shoulder Access Pass-CONCURRENT SESSION 4C: Throwing Shoulder and Elbow

Video Transcription

Video Summary

This video transcript is from a detailed medical symposium on shoulder and elbow injuries in overhead throwing athletes, particularly baseball players. The session begins with Dr. Ben Kibler introducing the concept of the "Sicily lesion," a more comprehensive understanding of labral injuries beyond the traditional SLAP lesion. He emphasizes that many clinically significant labral injuries occur posteriorly and inferiorly on the glenoid, not just superiorly as SLAP suggests. Kibler outlines the shoulder’s labral anatomy and mechanics, stressing the importance of repairing the labrum to restore joint stability without over-constraining, particularly avoiding excessive tightening around the biceps tendon to preserve throwing motion.<br /><br />Dr. Funakoshi presents a novel anterior glenohumeral capsule ligament reconstruction using hamstring grafts to treat anterior instability in throwing athletes, achieving good return-to-play rates by balancing stability and laxity.<br /><br />Kevin Wolk discusses risk factors for shoulder and elbow injuries, highlighting the rising incidence of UCL surgeries, especially related to pitch velocity, specialization, improper mechanics, and practices like weighted ball throwing. He underscores the importance of kinetic chain function, range of motion, and controlled training to mitigate injury.<br /><br />Dr. Jeff Grantham explains the role of internal brace UCL repair, noting good outcomes and quicker return to play in athletes with appropriate tissue quality, particularly for repair rather than full reconstruction in partial tears or end-avulsions.<br /><br />Throughout, the panel stresses restoring native anatomy (“just right” or “Goldilocks” repair), avoiding over-tightening the biceps anchor, cautious treatment of partial cuff tears, and individualized rehabilitation focusing on mechanics and kinetic chain.<br /><br />Case discussions illustrate the complexity of diagnosing and treating throwing shoulder injuries, emphasizing thorough examination, correct lesion identification, and tailored surgical and non-surgical approaches. The overall message promotes evolving, evidence-based, and nuanced management of throwing athletes’ shoulder and elbow injuries to maximize function and career longevity.

Asset Caption

Moderator: John D. Kelly IV, M.D., FAANA
William B. Kibler, M.D. | Tadanao Funakoshi, M.D., Ph.D. | Kevin E. Wilk, P.T., D.P.T. | Jeffrey R. Dugas, M.D. | William J. Grantham, M.D.

Keywords

Sicily lesion

labral injuries

SLAP lesion

shoulder anatomy

anterior glenohumeral capsule reconstruction

hamstring graft

UCL surgery

pitch velocity

internal brace UCL repair

kinetic chain function