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Suprascapular neuropathy in pitchers

Department of Neurology, University of Colorado School of Medicine, Denver, Colorado

Marc Treihaft, MD

Department of Neurology, University of Colorado School of Medicine, Denver, Colorado

Michael Carr, PhD

Department of Neurology, Department of Cellular and Structural Biology, University of Colorado School of Medicine, Denver, Colorado

Richard Fisher, MD

Department of Orthopedics, University of Colorado School of Medicine, Denver, Colorado

Paul Jacobs, MD

University of Colorado School of Medicine, Denver, Colorado

The clinical features and preoperative and postopera tive electrodiagnostic studies were reviewed in two professional pitchers with a suprascapular neuropathy. These studies demonstrate that denervation of the infraspinatus and/or supraspinatus muscle is not al ways due to entrapment of the nerve at the suprascap ular or spinoglenoid notches, as is often proposed. Similar studies in healthy pitchers during spring training and again at midseason demonstrate that slowing of suprascapular nerve conduction is detectable in some cases as the season progresses.

Sagittal sections of a cadaver with the arm fixed in the acceleration phase of the pitching motion demon strate five possible sites of trauma to the suprascapular nerve. Mechanisms proposed to explain these progres sive, but potentially reversible, changes include consid eration of biomechanical factors as well as anatomical features. An alternative hypothesis to nerve trauma that explains this symptom complex is intimal damage to the axillary or suprascapular artery and subsequent production of microemboli which become trapped in the suprascapular nerve vasa nervorum.

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