Segment 102.1: Athletico’s Overhead Athlete Program

Matt Gauthier, PT, DPT, SCS from Athletico Physical Therapy talks with Steve and Dr. Cole about the unique characteristics of the Overhead Athlete, types of overhead throwing injuries: causes, prevention and treatment.

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There’s more to throwing than just the motion of your arm.  There’s actually a whole science dedicated to it-and Athletico offers a comprehensive approach. Our team of physical therapists, occupational therapists, certified athletic trainers, and physical therapy assistants combine their expertise in throwing analysis with slow-motion video analysis to enhance performance and help prevent injuries.

Whether you are returning from an injury or simply working to refine mechanics, Athletico has skilled professionals to assist you in optimizing your form and preparing your body for the field of competition, bringing you one step closer to making your goals a reality.

Matt Gauthier specializes in the treatment of high-level athletes, and is the most passionate about treating shoulder and knee injuries. He is the head of Athletico’s Overhead Athlete Program,  and is a member of the USOC physical therapy volunteer program. As a sports specialist, he has experience treating athletic injuries at the youth, high school, college, professional, and Olympic levels.

Chicago Dogs Select Midwest Orthopaedics at Rush as Team Physicians

The Chicago Dogs LogoMidwest Orthopaedics at Rush has been selected as the official team physician for Chicago’s newest professional baseball team, the Chicago Dogs. MOR team physicians will be responsible for pre-season physicals and treating players’ orthopedic injuries or conditions during the season.

“The Chicago Dogs take great comfort knowing that our players will be cared for by the fifth-ranked orthopedic group in the country, including Drs. Brian Cole, Gregory Nicholson, and Jeremy Alland,” explains Chicago Dogs owner Shawn Hunter. “MOR physicians are national leaders in the field of sports medicine and we are proud to partner with them as we enter our inaugural season in Chicagoland.”

MOR doctors serves as team physicians for the Chicago Bulls, Chicago White Sox, and Chicago Fire Soccer Club, among others. They are using advanced techniques and have many subspecialty orthopaedic physicians on staff who  diagnose and treat even the most complicated and rare orthopedic conditions.  MOR physicians are supported by a professional staff of nurse practitioners; physician assistants; athletic trainers; physical and occupational therapists; and other administrative personnel.

“Our staff is looking forward to supporting this young baseball team and keeping them healthy and on the field,” Dr. Cole says. “Caring for pro athletes is our ‘sweet spot’ and we are ready to help them safely reach their goals this season.”


About The Chicago Dogs
The Chicago Dogs are the newest member of the American Association of Independent Professional Baseball. Home games are played at the state-of-the-art Impact Field located at 9800 Balmoral Avenue in Rosemont, Ill. For schedule and ticket information, visit www.thechicagodogs.com.

About Midwest Orthopaedics at Rush
MOR doctors are team physicians for the Chicago Bulls, Chicago White Sox, Chicago Fire Soccer Club and Joffrey Ballet, among others. They are known for treating patients with orthopedic conditions, ranging from the most common to the most complex. The group’s reputation as a leader in specialized orthopedic patient care, education and research has been recognized by many national publications. U.S. News & World Report ranks the orthopedic program at Rush University Medical Center, Chicago, as No. 5 in the nation and it is the highest ranked program in Illinois and Indiana.

Rotator Cuff Repair For Young Athletes: An Uncommon Operation With Excellent Results

By Dev Mishra, M.D., President, Sideline Sports Doc, Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • Rotator cuff tears requiring surgery are uncommon in young athletes
  • Surgery typically leads to excellent function and very high return to sports at the same level or higher, although overhead athletes may need to change positions

The rotator cuff is a term used to describe a group of four tendons at the top of the shoulder responsible for movement and stability of the shoulder joint. We’ll typically see rotator cuff tears in older athletes. In young athletes the most common issue with the rotator cuff is an overuse tendonitis, and occasionally a partial tear. A complete detachment of the rotator cuff from the bone is very uncommon in young athletes, but it can happen. When a detachment happens it will require surgery for the young person to have the best chance of full function. Fortunately surgery can lead to excellent results.

At the James Andrews sports medicine center in Birmingham, Alabama, they have quite a bit of experience with rotator cuff tears. In this published study, they report on 2-year follow up of young athletes with rotator cuff tears who underwent surgical repair. Attesting to the rarity of this problem, in an 8 year period at this very high volume clinic they identified 32 athletes (28 boys and 4 girls) with an average age 16 years.

Each athlete played at least 1 sport, and 27 athletes had no shoulder issues prior to the start of their pain. Twenty-nine of the 32 tears resulted from a traumatic event.

The athletes all had surgery at the Andrews Center. Overall, 25 patients (93%) returned to the same level of play or higher. Among overhead athletes, 13 (93%) were able to return to the same level of play, but 8 (57%) had to change positions.

Surgery for rotator cuff tears can lead to excellent outcomes in young athletes, but what we find from these results is that overhead athletes could have difficulties returning to the same position after surgery.Logo

If you’re a young athlete with a complete detachment of the rotator cuff you’ll likely need surgery to best restore shoulder function for sports as well as other activities. These uncommon injuries would best be managed by a physician with substantial experience in treating shoulder injuries.

There’s A Lot We Don’t Know About Baseball and Softball Injuries

By Dev Mishra, M.D., President, Sideline Sports Doc, Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • There are likely many factors involved in shoulder and elbow injuries for young throwers
  • The available data suggests that there are steps a young thrower can take now to minimize risk.
  • These steps include: play less than 8 months out of the year; play more than one sport; maintain shoulder motion as close to the non-throwing shoulder as possible; and improve lower extremity and core strength

I’m still thinking back on a recently published study of MRI abnormalities in young baseball players. I wrote about this in a blog post and noted that in this small study 100% of the players had an abnormal shoulder MRI scan if they were single sport athletes and played more than 8 months out of the year. Sure, a larger study will likely show a different percentage but it still should give us all reason to ask: why does this happen?  And why did 74% of young players report some arm pain during play in another study? Is this just the new normal, the physical price paid to play the sport? The data are compelling and a bit scary, but still it’s not easy to connect the dots and identify specific causes of problems. There’s a lot we still don’t know.

There is a lot of outstanding research taking place now, attempting to answer the question: “why”. We’ll likely find that there are several factors that can conspire together to create injury risk, loss of performance, and loss of sport enjoyment. I’d like to highlight a few excellent studies recently published in the journal Sports Health.

Here’s an excellent study that starts to define what the normal pitching motion should look like in a young pitcher. The authors defined ranges for the normal shoulder rotation and elbow load and found interestingly that loads are actually less for curveballs compared to fastballs, and yet current pitching recommendations suggest avoidance of curveballs until around age 14. The culprit may actually be abnormal lower extremity and trunk mechanics in the young pitcher. Possible solutions: lower extremity and core strength should be a conditioning focus for the young thrower.

In another study the authors did a retrospective analysis of previously published data and found that shoulder rotational deficits correlated with risk of shoulder and elbow injuries in early adulthood. These authors feel that with the onset of puberty and the accelerated growth in the young body, it seems that repetitive overhead activity leads to changes in bone shape. Once the young thrower is finished growing the continued repetitive stress in throwing is transmitted to the soft tissues. Possible solution: improve shoulder, elbow, and trunk range of motion with a program such as the Yokohama Baseball-9.Sideline Sports Doc Logo

These and other studies point to the fact that there are multiple factors involved in creating the recipe for upper extremity injury. There’s a lot we still don’t fully understand. But there are reasonable steps any young thrower can take right now to reduce injury risk and maximize sport performance and enjoyment. Play less than 8 months in a year and play more than one sport. Keep shoulder motion as close to the non-throwing shoulder as possible, and keep lower extremity and core strength up.