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Show 33 college of health Background: This case follows the evaluation, assessment, and management of suprascapular neuropathy in a right handed collegiate male baseball pitcher. In May 2010 the athlete complained of extreme right shoulder pain after pitching 4 innings with no decrease in velocity. Initial assessment revealed pain and weakness in external rotation. Examination by the team physician revealed severe infraspinatus atrophy and scapular dyskinesis. An MRI was conducted to check for a ganglion cyst. The MRI revealed no space occupying lesions. Follow up Electro Myography (EMG) testing revealed a deficit in neuromotor signal conduction of the right suprascapular nerve. At the team physician's recommendation a conservative treat-ment plan was implemented. The athlete was cleared for full participation in January 2011. Differential Diagnosis: Rotator cuff strain, labral tear, impingement syndrome, traction injury to brachial plexus, space occupying lesion. Treatment: Conservative treatment progressed over a 6 month period, after which EMG testing revealed no significant deficiency of the right suprascapular nerve. The athlete was cleared for full participation. After two months the athlete complained of returning signs and symptoms. Evaluation revealed atrophy of the infraspinatus and weakness in external rotation. Further EMG testing confirmed a deficiency of neuromo-tor impulse conduction of the right suprascapular nerve. The athlete made the decision to try a non-tra-ditional conservative treatment approach known as Accelerated Recovery Performance wave (ARP-wave) therapy. With no progress resulting from the ARP-wave therapy the athlete underwent a surgical proce-dure to decompress the suprascapular nerve in May 2011. Conservative rehabilitation was implemented. The athlete was cleared for full participation in January 2012 Uniqueness: Suprascapular nerve compression is considered to be a rare diagnosis and is frequently misdi-agnosed as a rotator cuff or labral tear. Untreated this condition has the potential to end an athlete's career, and severely effect quality of life. Conclusions: Suprascapular nerve compression is being more frequently diagnosed in athletes performing repetitive overhead movements. It is hoped that by presenting this case athletic trainers will improve their ability to recognize suprascapular neuropathy and apply appropriate interventions. SUPRASCAPULAR NEUROPATHY IN A COLLEGIATE MALE BASEBALL PLAYER Jacob K. Pattillo (Charlie Hicks-Little, Eric Yochem, Craig Chelette) Department of Exercise and Sport Science, Athletic Training Program University of Utah UNDERGRADUATE RESEARCH ABSTRACTS Charlie Hicks-Little Jacob K. Pattillo |
