0:00

Many muscle strains.

0:02

On your left is a list of some of the locations of them.

0:06

I wanted to show you this one.

0:07

This is a strain of the latissimus Dorsey,

0:10

and by the way, its attachment

0:12

and its anatomy intimate with the Terry's major.

0:15

And they may share a singular attachment on the humerus.

0:19

This one was involvement of the Latisimus uh Dorsey.

0:24

And then the other muscle injury

0:26

that occurs in the throwing shoulder

0:28

occupies the lower portion of the subscapularis.

0:32

Because you see an abduction

0:33

and external rotation, the

0:36

subscapularis myo tendonous junction is stress over

0:40

or stretch over the humeral head in the late

0:43

Hocking phase of throwing.

0:45

So you'll end up with tearing of that muscle

0:48

hematomas within that muscle.

0:51

A number of neurovascular injuries may occur,

0:55

particularly in those patients who have labral tears

0:58

and paralabral ganglia in cyst.

1:01

I showed you this case yesterday.

1:03

This is a paralabral ganglia insist the patient had labral

1:07

pathology extending into the spinal glenoid notch, leading

1:11

to an entrapment neuropathy at the suprascapular nerve

1:16

and those nerves that we're occupying

1:19

or supplying the in infraspinatus muscle,

1:21

which you can see is emus.

1:24

And then another thing that is the quadrilateral space,

1:28

and you may get problems there.

1:30

As you remember, there are two major things that go in

1:33

through the quadrilateral space, the axillary nerve,

1:37

so you may get an entrapment of that

1:39

or an injury to the posterior circumflex humeral artery.

1:43

This was a very, very famous professional baseball pitch

1:47

who came in with cyanotic fingers.

1:50

And what they found, he had complete thrombosis

1:53

of the posterior circumflex humal artery with a catheter.

1:57

They were able to open it up

2:00

and he returned to pitching that same year

2:03

and did quite well.

2:04

He was a very successful pitcher.

2:07

There's one soft tissue lesion

2:09

that we have seen in a few baseball pitchers,

2:12

and it is the ELAs fibroma.

2:15

You know it best in its common location along the,

2:19

or deep to the inferior aspect of the scapula.

2:22

But friction develops between the scapula

2:25

and muscles and the ribs.

2:26

And so baseball pitchers may develop ELAs of fibro.

2:32

They appear as low signal intensity structures are sometimes

2:36

with fat also within them.